TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: Improper reprocessing of bronchoscopes poses a serious patient safety and infection risk. The risk of patient infection resulting from use of contaminated bronchoscopes has been reported to be 2.8%. Recently, medical device manufacturers have introduced single-use flexible bronchoscopes (SFB) as an alternative to reusable flexible bronchoscopes (RFB). By virtue of being sterile, SFB may reduce the infection risk, subsequent readmission rates, and associated costs while enhancing operational efficiency. METHODS: Bronchoscopies with SFB and RFB were identified along with their corresponding readmission information in the Premier Healthcare Database (PHD) from 2016-2019. Summary statistics were calculated on readmissions segmented by scope type and clinical setting. A logistic regression analysis was conducted with 30-day readmission as the dependent variable. Independent variables included use of a RFB, gender, race, age, payer, and discharge status. For the inpatient setting, the 3M™ APR DRG Severity of Illness classification was included as an independent variable. RESULTS: A total of 14,228 procedures identified, of which 1,795 used SFB and 12,433 used a RFB (9,401 outpatient and 4,827 inpatient). In the inpatient setting, the RFB group was ~2.5 times more likely to be readmitted within 30 days compared to the SFB group (OR=2.5, p<0.01), controlling for patient demographics and risk. In the outpatient setting, the RFB group was ~1.5 times more likely to be readmitted than the SFB group (OR=1.5, p>0.05). Across all settings, the RFB group was ~2.3 times more likely to be readmitted than the SFB group (OR=2.3, p<0.01). The inability to fully risk-adjust in the outpatient setting may have been a factor in the smaller OR and lack of statistical significance; this limitation will be addressed with further analysis that includes an outpatient severity of illness classification variable. CONCLUSIONS: The data analysis demonstrates significant clinical benefits of SFB in reducing readmissions and risks. CLINICAL IMPLICATIONS: Medical Device Adverse Event Reports continue to be filed with the United States Food and Drug Administration indicating that RFB can serve as a vector for cross-contamination and potential device-related infections in patients. Patients undergoing bronchoscopy typically have significant comorbidities which increase their risk for the development of potential device-related infections. To reduce these risks, the use of a sterile SFB should be considered to eliminate reprocessing failures, improve overall operational efficiency, and reduce potential acquisition of healthcare-associated infections. Recent data from FDA 522 studies in the gastrointestinal clinical setting has demonstrated the widespread risks associated with reusable flexible endoscopes. These lessons learned must be adapted to the clinical procedure of bronchoscopy, especially in an era of an ongoing global pandemic. DISCLOSURES: Consultant relationship with Ambu Please note: 2020-2021 Added 04/21/2021 by John Garrett, source=Web Response, value=Consulting fee Consultant relationship with Owens and Minor Please note: 2020-2021 Added 04/20/2021 by John Garrett, source=Web Response, value=Consulting fee Advisory Committee Member relationship with Clorox Professional Please note: 2020-2021 Added 04/21/2021 by John Garrett, source=Web Response, value=Consulting fee