Peri-procedural code status discussions before bronchoscopy: A cross-sectional survey of German and Swiss pulmonologists
6 affiliations
- 1Medical Communication / Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- 2Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
- 3Department of Anesthesiology, University Hospital Basel, Basel, Switzerland
- 4Faculty of Medicine, University of Basel, Basel, Switzerland
- 5Clinic of Respiratory Medicine, University Hospital Basel, Basel, Switzerland
- 6Post- Intensive Care Clinic, University Hospital Basel, Basel, Switzerland
Abstract
Introduction: In-hospital cardiac arrest is associated with poor outcomes, yet peri-procedural code status discussions before bronchoscopy may be inconsistent, particularly in patients with elevated procedural risk.
Methods: We conducted an anonymous online survey of a convenience sample of hospital-based pulmonologists in Germany and Switzerland between April and July 2025. The survey assessed routine practices and attitudes regarding peri-procedural code status discussions, risk stratification, and management of patients with pre-existing No-CPR status. Owing to distribution through multiple channels and secondary forwarding, a precise response rate could not be calculated.
Results: A total of 148 pulmonologists participated (mean age 47.8 years; 94.6% board-certified). Discussions regarding CPR preferences were conducted almost always or most of the time before high-risk bronchoscopies by 67.6% of respondents, but were rarely or almost never performed before low-risk procedures by 72.0%. Respondents more frequently reported procedural risk than patient-related factors as a trigger for these discussions. Periprocedural No-CPR status was considered controversial by 44.9%, and responsibility for these discussions varied among respondents. Only 25% reported formal institutional training.
Conclusions: Substantial variability exists in peri-procedural code status practices before bronchoscopy. Clearer responsibilities and structured guidance are needed to better align care with patient preferences.
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BibTeX
@article{gossi2026periprocedural,
title = {{Peri-procedural code status discussions before bronchoscopy: A cross-sectional survey of German and Swiss pulmonologists}},
author = {Flavio Gössi and Armon Arpagaus and Benjamin Bissmann and Samuel Kaspar Zumbrunn and Thierry Girard and Jürgen Hetzel and Kathleen Jahn and Katrin E Hostettler and Sabina Hunziker},
journal = {Multidisciplinary Respiratory Medicine},
year = {2026},
month = sep,
doi = {10.5826/mrm.2026.1098},
url = {https://doi.org/10.5826/mrm.2026.1098},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Peri-procedural code status discussions before bronchoscopy: A cross-sectional survey of German and Swiss pulmonologists
AU - Flavio Gössi
AU - Armon Arpagaus
AU - Benjamin Bissmann
AU - Samuel Kaspar Zumbrunn
AU - Thierry Girard
AU - Jürgen Hetzel
AU - Kathleen Jahn
AU - Katrin E Hostettler
AU - Sabina Hunziker
PY - 2026
DA - 2026/09/03
JO - Multidisciplinary Respiratory Medicine
DO - 10.5826/mrm.2026.1098
UR - https://doi.org/10.5826/mrm.2026.1098
AB - Introduction: In-hospital cardiac arrest is associated with poor outcomes, yet peri-procedural code status discussions before bronchoscopy may be inconsistent, particularly in patients with elevated procedural risk. Methods: We conducted an anonymous online survey of a convenience sample of hospital-based pulmonologists in Germany and Switzerland between April and July 2025. The survey assessed routine practices and attitudes regarding peri-procedural code status discussions, risk stratification, and management of patients with pre-existing No-CPR status. Owing to distribution through multiple channels and secondary forwarding, a precise response rate could not be calculated. Results: A total of 148 pulmonologists participated (mean age 47.8 years; 94.6% board-certified). Discussions regarding CPR preferences were conducted almost always or most of the time before high-risk bronchoscopies by 67.6% of respondents, but were rarely or almost never performed before low-risk procedures by 72.0%. Respondents more frequently reported procedural risk than patient-related factors as a trigger for these discussions. Periprocedural No-CPR status was considered controversial by 44.9%, and responsibility for these discussions varied among respondents. Only 25% reported formal institutional training. Conclusions: Substantial variability exists in peri-procedural code status practices before bronchoscopy. Clearer responsibilities and structured guidance are needed to better align care with patient preferences.
SN - 1828-695X
SN - 2049-6958
ER -