<b><i>Background:</i></b> Ultrathin bronchoscopy (external diameter, ≤3.5 mm) is useful for the diagnosis of peripheral pulmonary lesions because of its good accessibility. <b><i>Objectives:</i></b> We performed a meta-analysis to investigate the diagnostic yield of ultrathin bronchoscopy for peripheral pulmonary lesions. <b><i>Methods:</i></b> We performed a systematic search of MEDLINE and EMBASE (from inception to May 2021), and meta-analysis was performed using R software. The diagnostic yield was evaluated by dividing the number of successful diagnoses by the total number of lesions, and subgroup analysis was performed to identify related factors. <b><i>Results:</i></b> Nineteen studies with a total of 1,977 peripheral pulmonary lesions were included. The pooled diagnostic yield of ultrathin bronchoscopy was 0.65 (95% confidence interval, 0.60–0.70). Significant heterogeneity was observed among studies (χ², 87.75; <i>p</i> &#x3c; 0.01; <i>I</i>², 79.5%). In a subgroup analysis, ultrathin bronchoscopy with 1.2 mm channel size showed a diagnostic yield of 0.61 (95% confidence interval, 0.53–0.68), whereas ultrathin bronchoscopy with 1.7 mm channel size showed 0.70 (95% confidence interval, 0.66–0.74) (χ², 5.35; <i>p</i> = 0.02). In addition, there was a significant difference in diagnostic yield based on lesion size, histologic diagnosis (malignant vs. benign), bronchus sign, and lesion location from the hilum, whereas no significant difference was found based on lobar location. The overall complication rate of ultrathin bronchoscopy was 2.7% (pneumothorax, 1.1%). <b><i>Conclusions:</i></b> Ultrathin bronchoscopy is an excellent tool for peripheral pulmonary lesion diagnosis with a low complication rate. The diagnostic yield of ultrathin bronchoscopy was significantly higher with larger channel size, which might be attributed to the availability of radial endobronchial ultrasound.

The main purpose of this study was to develop a model predictive of dysphagia in hospital survivors with severe pneumonia who underwent tracheostomy during their hospital stay. The present study included 175 patients (72% male; mean age, 71.3 years) over 5 years. None of these patients had a history of deglutition disorder before hospital admission. Binary logistic regression analysis was performed to identify factors predicting dysphagia at hospital discharge. Dysphagia scores were calculated from β-coefficients and by assigning points to variables. Of the enrolled patients, 105 (60%) had dysphagia at hospital discharge. Factors prognostic of dysphagia at hospital discharge included being underweight (body mass index < 18.5 kg/m2), non-participation in a dysphagia therapy program, mechanical ventilation ≥ 15 days, age ≥ 74 years, and chronic neurologic diseases. Underweight and non-participation in a dysphagia therapy program were assigned +2 points and the other factors were assigned +1 point. Dysphagia scores showed acceptable discrimination (area under the receiver operating characteristic curve for dysphagia 0.819, 95% confidence interval: 0.754–0.873, p < 0.001) and calibration (Hosmer–Lemeshow chi-square = 9.585, with df 7 and p = 0.213). The developed dysphagia score was predictive of deglutition disorder at hospital discharge in tracheostomized patients with severe pneumonia.

Background: This study aimed to investigate the association between the Korean national health insurance coverage benefit extension policy and clinical outcomes of patients who were ventilated owing to various respiratory diseases.Methods: Data from 515 patients (male, 69.7%; mean age, 69.8±12.1 years; in-hospital mortality rate, 28.3%) who were hospitalized in a respiratory intensive care unit were retrospectively analyzed over five years.Results: Of total enrolled patients, 356 (69.1%) had one benefit items under this policy during their hospital stay. They had significantly higher medical expenditure (total: median, 23,683 vs. 12,742 USD, P<0.001), out-of-pocket (median, 5,932 vs. 4,081 USD; P=0.008), and a lower percentage of out-of-pocket medical expenditure relative to total medical expenditure (median, 26.0% vs. 32.2%; P<0.001). Patients without benefit items associated with higher in-hospital mortality (hazard ratio [HR], 2.825; 95% confidence interval [CI], 1.995–4.000; P<0.001). In analysis of patients with benefit items, patients with three items (“cancer”, “tuberculosis,” and “disability”) had significantly lower out-of-pocket medical expenditure (3,441 vs. 6,517 USD, P<0.001), and a lower percentage of out-of-pocket medical expenditure relative to total medical expenditure (17.2% vs. 27.8%, P<0.001). They were associated with higher in-hospital mortality (HR, 3.996; 95% CI, 2.535–6.295, P<0.001).Conclusions: Our study showed patients with benefit items had more medical resources and associated improved in-hospital survival. Patients with the aforementioned three benefit items had lower out-of-pocket medical expenditure due to the implementation of this policy, but higher in-hospital mortality.

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