A study published in Anaesthesia concluded there is a 2.8 percent risk of patient infection post-bronchoscopy when a reusable bronchoscope is used.
Ventilator-associated pneumonia and sepsis are among the infections that can result. They can require extended and costly hospital stays.
“What I wish the general public knew is that infection rates are higher than they probably expect, and that goes across different areas of endoscopy,” said Russ Montgomery, director of health economics and market access for North American at Ambu Inc., during an Ambu-sponsored clinical education webinar. “When they have a bronch done, there is a risk to them not only of infection but also the out-of-pocket costs associated with that.”
The “Bronchoscopy During COVID-19” webinar series features doctors telling their stories from the frontlines of the pandemic in New York City, Los Angeles and Chicago. It also explores recommendations from Dr. Hudson Garrett Jr., an expert in infection prevention, on best practices to reduce risk during bronchoscopy.
In addition to reducing the risk of cross-contamination, single-use bronchoscopes are also more cost effective, Montgomery said. When reprocessing costs and infection treatment are factored in, the cost per procedure for a single-use bronchoscope totals about $300. That compares with about $326 in direct costs per procedure for a reusable scope, a total that increases to $656 when you add in the costs of treating infections.
Reusable endoscopy systems require massive capital outlay for video towers and the scopes themselves. Those endoscopes need to be reprocessed after each use and periodically repaired.
These are all important patient safety and financial considerations in economically uncertain times such as these brought on by SARS-CoV-2.
“As you get into more advanced reprocessing methods, the costs go up,” Montgomery said. “COVID-19 is resulting in needed changes that make reprocessing guidelines more stringent, but that also makes reprocessing more expensive.”
The 2.8 percent infection risk that Montgomery cited in the Ambu webinar was based on a review of 16 studies from six different countries. That study – by J.M. Mouritsen, L. Ehlers, J. Kovaleva, I. Ahmad and K. El-Boghdadly and titled “A systematic review and cost effectiveness analysis of reusable vs. single-use flexible bronchoscopes” – included 3,120 procedures that resulted in 476 cases of patient contamination.
Among those, there were 86 infections linked to bronchoscopes. Pulling out the eight studies that were conducted in the U.S., the infection rate was 3.6 percent.