The Characteristics and Outcomes of Foreign Body Aspiration and Ingestion in Pediatric Patients who Visit an Emergency Department

ABSTRACT

PURPOSE: Many children visit an emergency department with aspiration or ingestion of a foreign body (FB). As little study based on Korean domestic data has been reported, we conducted a retrospective study in order to investigate the characteristics and outcomes in pediatric patients with FB. METHODS: A retrospective chart review of children with FB aspiration or ingestion who visited one of three emergency departments between January 2009 and December 2012 was conducted. Demographic data including age and sex, time of accident, whether the event was witnessed, time to visit, symptoms, radioopacity, diagnostic and therapeutic modalities, and category of FB were recorded. Stepwise forward logistic regression was performed in order to verify the association between variables and confirmation of FB. RESULTS: A total of 1508 pediatric patients presented to the emergency departments with FB aspiration or ingestion 739(49%) patients were 0 to 3 years old; 922(61.1%) patients visited with food itself or food-related materials, including fishbone. A total of 534(35.4%) patients were finally confirmed as having FB. Of those, the Odds ratio of positive radiologic test in patients presenting with a certain sign or symptom was 1.412(95% Confidence interval, 1.133 to 1.759). The proportion of those witnessed was significantly higher in those confirmed with FB than in those not confirmed (p<0.001). CONCLUSION: An emergency physician should take a detailed history, including whether there is a witness, and perform a careful examination in order to make a decision regarding the need for diagnostic and therapeutic modality when a pediatric patient is under three years old, and has no symptom or positive radiologic finding.