Poster abstracts, 11th Annual British Thoracic Oncology Group Conference, 2013: Diagnosis & Staging
2010 2011 2012 Overall <1 cm nodes
Negative predictive value
84.4% 88.5% 95.9% 92.6% 83.3%
73.1% 85.7% 93.8% 89.2% 94.1%
89.1% 93.2% 97.5% 95.4% 95.4%
8.5% 5.8% 4.3% 5.3% 12%
The NSCLC-NOS rate is 6.8%. There have been 2 major complications (0.4%); sedation reversal for hypoxia post procedure and overnight admission following a 50 ml post-procedure haemoptysis. The minor complication rate is 7.7% (the most common being poor tolerance requiring early termination of the procedure). Conclusions: The UHSM EBUS-TBNA service provides a highly accurate and safe service that is improving year on year. We have a very low NSCLC-NOS rate. We will continue to analyse and publish our service performance. 71 Patient satisfaction with bronchoscopy and EBUS S. Ghafur *, P. Patel, M. Thirumaran, P. Blaxill. Pinderﬁelds General Hospital, UK Background: Fibreoptic bronchoscopy remains the commonest invasive procedure used in the diagnosis of lung cancer. The advent of EBUS has improved the ability to make a rapid diagnosis. Patient satisfaction has become a signiﬁcant component of health care outcomes and an important measure of quality assessment. Aims: To assess overall patient satisfaction with procedure Physician assessment of patient sedation If degree of sedation affected satisfaction. Methods: This was a prospective survey of patients attending for bronchoscopy/EBUS over a three month period. Patients were given a questionnaire to take home to complete. Satisfaction was measured using a 5 point Likert scale. Results: 59 patients agreed to take part with a 96% response rate. From the physicians’ perspective 79% of patients were well sedated prior to the procedure. Overall, the physicians felt that 65% of the patients tolerated the procedure well/very well. The physicians performing the procedures felt that 47% of the procedures were very easy/easy with regards to sampling. 87% of patients received an information leaﬂet prior to the procedure. The commonest post procedural symptoms experienced were haemoptysis and sore throat. 76% of patients found the procedure comfortable/very comfortable with 89% of patients being satisﬁed/very satisﬁed with the amount of sedation. If necessary 78% of patients would have the procedure repeated. Patients were given an average of 3.8 mg of midazolam. 49% of patients received 4 mg or more of midazolam. Out of these patients, 42% of patients found the procedure very comfortable. 50.8% of patients had 3 mg or less of midazolam and out of these patients, only 34% of patients rated the procedure as being very comfortable. Conclusion: From this survey, we can conclude that bronchoscopy and EBUS are both well tolerated procedures. The results show that higher doses of midazolam correlate with increased patient satisfaction with comfort through the procedure. 72 Patient satisfaction with thoracoscopy S. Ghafur *, R. Naseer, M. Thirumaran, P. Blaxill. Pinderﬁelds General Hospital, UK Background: Thoracoscopy is the gold standard investigation in exudative pleural effusions in which a diagnostic pleural tap has been negative and there is a high suspicion of an underlying
malignancy. Patient satisfaction has become a signiﬁcant component of health care outcomes. Aims: Assess overall patient satisfaction with procedure Assess patient satisfaction with sedation Physician assessment of patient sedation Method: This was a prospective survey of patients attending for thoracoscopy over a three month period. An average of 50 procedures per year are done at Mid Yorkshire NHS Trust. Patients were given a questionnaire to take home and return it using a prepaid envelope. The physician carrying out the procedure ﬁlled out a corresponding questionnaire. Satisfaction was measured using a 5 point Likert scale. Results: 13 patients agreed to participate in the audit with nine returning the questionnaire. From the physician reports, 91% of patients were well sedated prior to the procedure. Overall, the physicians’ perception was that the patients tolerated the procedure well, with only 16.7% scoring less than 3 on the Likert scale (1 = very poor, 5 = very good). The mean score for ease of sampling was 2.8 (1 = very easy, 5 = very hard). Patients were given an average of 9.5 mg of morphine and 5 mg of midazolam for sedation. 77% of patients received an information leaﬂet prior to the procedure. The commonest post procedural side effect experienced was pain. 77% of the patients found the procedure very comfortable with 88% of the patients being very satisﬁed with the amount of sedation. 77% of patients would have the procedure repeated if necessary. Conclusion: Thoracoscopy is a very useful tool used in the diagnosis of pleural disease. The survey shows that patients tolerate the procedure well. The results have shown that patients tolerate the procedure better than the physicians’ perception of patient tolerance.
Figure 1. Graph showing patient tolerance of procedure.
73 Patient perceived discomfort at awake sedation thoracoscopy S. Tarique *, D. O’Neill, S. Power, K. Pink, J. Wooley, I.J. Williamson, A.A. Ionescu. Royal Gwent Hospital Aneurin Bevan HB, UK Background: Awake sedation thoracoscopy is increasingly used in the UK for the diagnosis and management of malignant pleural effusions. Aim: To asses patient perceived discomfort during the procedure assessed immediately after thoracoscopy and at follow up appointment 7 10 days later. Methods: This is a service assessment over 1 year; data was acquired prospectively. A ﬁve point scale (0 no discomfort to 5 severe discomfort) was presented to the patients in recovery once awake and at the follow up appointment. In recovery a nurse-perceived discomfort score was also recorded (none, minimal, moderate or severe). Midazolam was used for sedation and was administered by a