Abstract
Background
Airway foreign bodies (FB) are a common medical emergency within the pediatric population. While deaths are not uncommon, the in-hospital mortality rates and correlation with anatomic location of the airway foreign body have not been previously reported.
Methods
The KID database was reviewed for 2003, 2006, 2009, and 2012 for pediatric patients with a discharge diagnosis of airway foreign body using ICD-9 codes (933.1, 934.x).
Results
11,793 patients, ages 0–17, were found to have an airway FB. Of patients admitted for airway FB 21.2 % required mechanical ventilation during their hospitalization, and the overall mortality rate was 2.5 %. Location of the airway FB was dependent on age (p < 0.01). Use of mechanical ventilation was dependent on the location of the airway FB (p < 0.01) and being transferred from another hospital (OR 2.59, p < 0.01). Univariate analysis demonstrated differences in in-hospital mortality based on location (p < 0.01), use of a ventilator during hospitalization (OR 24.4, p < 0.01), and transfer from another hospital (OR 2.11, p < 0.01).
Conclusions
The in-hospital mortality rate for airway foreign bodies is 2.5 %. The anatomic location of airway FB in pediatric patients varies by age, and affects the need for mechanical ventilation and in-hospital mortality.
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References
Baharloo F, Veyckemans F, Francis C, Biettlot MP, Rodenstein DO (1999) Tracheobronchial foreign bodies: presentation and management in children and adults. Chest 115:1357–1362. doi:10.1378/chest.115.5.1357
Tan H, Brown K, McGill T, Al E (2000) Airway foreign bodies (FB): a 10-year review. Int J Ped Otor 56:91–99
Saki N, Nikakhlagh S, Heshmati S (2015) 25-year review of the abundance and diversity of radiopaque airway foreign bodies in children. Indian J Otolaryngol Head Neck Surg 67:261–266
National Safety Council (2015) Injury facts 2015. http://www.nsc.org/learn/safety-knowledge/Pages/injury-facts.aspx. Accessed 12 Oct 16
American Academy of Pediatrics (2010) Prevention of choking among children. Pediatrics 125:601–607. doi:10.1542/peds.2009-2862
Ayed A, Jafar A, Owayed A (2003) Foreign body aspiration in children: diagnosis and treatment. Pediatr Surg Int 19:485–488
Casalini AG, Majori M, Anghinolfi M, Burlone E, D’Ippolito R, Toschi M et al (2013) Foreign body aspiration in adults and in children. J Bronchol Interv Pulmonol 20:313–321. doi:10.1016/j.cpem.2015.07.002
Boufersaoui A, Smati L, Benhalla KN, Boukari R, Smail S, Anik K et al (2013) Foreign body aspiration in children: experience from 2624 patients. Int J Pediatr Otorhinolaryngol 77:1683–1688. doi:10.1016/j.ijporl.2013.07.026
Sahin A, Meteroglu F, Eren S, Celik Y (2013) Inhalation of foreign bodies in children: experience of 22 years. J Trauma Acute Care Surg 74:658–663. doi:10.1097/TA.0b013e3182789520
Zhang X, Li W-X, Cai Y-R (2015) A time series observation of Chinese children undergoing rigid bronchoscopy for an inhaled foreign body: 3149 cases in 1991–2010. Chin Med J (Engl) 128:504–509. doi:10.4103/0366-6999.151104
Healthcare Cost and Utilization Project (HCUP) (2016) Kids’ inpatient database (KID). HCUP; 2003, 2006, 2009, Rockville
Shlizerman L, Mazzawi S, Rakover Y, Ashkenazi D (2010) Foreign body aspiration in children: the effects of delayed diagnosis. Am J Otolaryngol 31:320–324. doi:10.1016/j.amjoto.2009.03.007
Huankang Z, Kuanlin X, Xiaolin H, Witt D (2012) Comparison between tracheal foreign body and bronchial foreign body: a review of 1,007 cases. Int J Pediatr Otorhinolaryngol 76:1719–1725. doi:10.1016/j.ijporl.2012.08.008
Gupta R, Nyakunu RP, Kippax JR (2016) Is the emergency department management of ENT foreign bodies successful? A tertiary care hospital experience in Australia. Ent Ear Nose Throat J 95(3):113–116
Foltran F, Ballali S, Passali FM, Kern E, Morra B, Passali GC et al (2012) Foreign bodies in the airways: a meta-analysis of published papers. Int J Pediatr Otorhinolaryngol 76:12–19. doi:10.1016/j.ijporl.2012.02.004
Foltran F, Ballali S, Rodriguez H, Sebastian van As AB, Passali D, Gulati A et al (2013) Inhaled foreign bodies in children: a global perspective on their epidemiological, clinical, and preventive aspects. Pediatr Pulmonol 48:344–351. doi:10.1002/ppul.22701
Erasmus CE, van Hulst K, Rotteveel JJ, Willemsen MAAP, Jongerius PH (2012) Clinical practice: swallowing problems in cerebral palsy. Eur J Pediatr 171:409–414. doi:10.1007/s00431-011-1570-y
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Johnson, K., Linnaus, M. & Notrica, D. Airway foreign bodies in pediatric patients: anatomic location of foreign body affects complications and outcomes. Pediatr Surg Int 33, 59–64 (2017). https://doi.org/10.1007/s00383-016-3988-9
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DOI: https://doi.org/10.1007/s00383-016-3988-9