Ingested foreign bodies causing complications and requiring hospitalization in European children: results from the ESFBI study.

BACKGROUND: In young children, particularly those aged 1-3 years, aerodigestive tract foreign bodies (FB) are a common pediatric problem. The aim of the present study was therefore to characterize the risk of complications and prolonged hospitalization due to FB in the upper digestive tract in terms of the characteristics of the injured patients (age, gender), typology and features of the FB, the circumstances of the accident and hospitalization details. METHODS: A retrospective study was done in 19 hospitals in 19 corresponding European countries of 186 cases of injury due to the presence of an FB in the mouth, esophagus and stomach (ICD935), out of the 2103 overall cases of FB reported in other locations. RESULTS: Complications arose in 14 cases and hospitalization was required in 164 cases. No deaths were observed. A higher incidence of hospitalization in male patients (61%) was observed. Median age for children who experienced complications was 2 years old. The most common FB removal technique was esophagoscopy. In the majority of cases the children were treated by the ENT Department. The most common FB were coins, batteries and fish bones among food. CONCLUSION: Because batteries, as well as coins and fish bones among food were the most common type of FB encountered, and because recent development of technology has accelerated broad use of disk-type batteries, parents should be aware of this hazard, and an educational campaign for public education for this serious problem is advisable.

Foreign bodies in the ears causing complications and requiring hospitalization in children 0-14 age: results from the ESFBI study.

OBJECTIVE: The occurrence of foreign bodies (FBs) in otorhinolaryngological practice is a common and serious problem among patients in paediatric age. The aim of this work is to characterize the risk of complications and prolonged hospitalization due to foreign bodies in ears in terms of the characteristics of the injured patients (age, gender), typology and features of the foreign bodies, the circumstances of the accident and the hospitalization's details. METHODS: A retrospective study in major hospitals of 19 European countries was realized on children aged 0-14 with regard to the characteristics of the injured child and the FB, the circumstances of the accident and finally the hospitalization's details. RESULTS: Four hundred and ninety eight cases were reported with an injury due to insertion of a FB in the ear (ICD931). Complications were observed in 65 (13.05%) children. Complications were lesion of auricular canal, perforation of tympanic membrane, local inflammation, bleeding, pain and otitis. Hospitalization lasted in median 1 day. The 82% of hospitalized children are in the "day hospital" regimen. The spherical, rigid and inorganic FB caused hospitalization in 61%, 63% and 84% of cases, respectively. CONCLUSION: Foreign body injuries in the ears are commonly encountered in clinical practice. The removal by non-ENT personnel can be associated to complications especially in children who have a variable level of cooperation. Occasions for the injury were mostly playing in the absence of watchful caregivers. Since prevention is the most essential way to deal with FB injuries public education should be encouraged.

Foreign bodies in the nose causing complications and requiring hospitalization in children 0-14 age: results from the European survey of foreign bodies injuries study.

INTRODUCTION: The occurrence of foreign bodies (FB) in otorhinolaryngological practice is a common and serious problem among pediatric patients. The aim of this work is to characterize the risk of complications and prolonged hospitalization due to FBs in the nose in terms of the characteristics of the injured patients (age, gender), typology and features of the FBs, the circumstances of the accident and the hospitalization's details. MATERIALS AND METHODS: A retrospective study of FB associated injuries, assessing the characteristics of the injured child and the FB, the circumstances of the accident and finally the hospitalization details took place on children aged 0-14 in major hospitals of 19 European countries. RESULTS: In total 688 cases were assessed. Complications and hospitalization occurred in 59 and 52 cases, respectively. Over 51% of patients were females. The median age of children who experienced a complication was four years. In the majority of cases FB removal was accomplished by means of a non-invasive technique (rhinoscopy with a nasal speculum or rigid fiberoptic endoscope. The majority of children were directly referred to the ENT department. The most common FBs associated with complications and hospitalization were nuts, seeds, berries, corn and beans, batteries and other inorganic objects such as broken parts of pens, paper clips and pearls. Over 38% of the injuries occurred under adults' supervision. DISCUSSION: FB injuries in the nose are commonly encountered in clinical practice. Even if the presence of a FB is not usually life threatening, it may result in long-term complications such as perforation of the septum. Because the risks associated with FB injuries, public education about this problem is recommended.

Foreign bodies in the upper airways causing complications and requiring hospitalization in children aged 0-14 years: results from the ESFBI study.

Foreign body (FB) aspiration/inhalation is a serious problem because it is still a cause of death in children, especially among those younger than 4 years. The objective of this paper is to characterize the risk of complications and prolonged hospitalization due to foreign bodies (FB) in the upper airways in terms of the characteristics of the injured patients (age, gender), typology and features of the FBs, the circumstances of the accident and the hospitalization details. A retrospective study in the major hospitals of 19 European countries was realized on injuries occurred in the years 2000-2002 and identified by means of the International Classification of Diseases, Ninth Revision (ICD-9) codes listed on hospital discharge records. In 170 cases, it was reported an injury due to the presence of a FB in the pharynx and larynx (ICD933) and in 552 records, it was reported a FB located in the trachea, bronchi and lungs (ICD934). Unlike the complications that occurred in 70 (12.7%) of cases, the hospitalizations were present in 433 (77.6) of the total injuries. One patient died. A higher incidence in males (63%) was observed. Median age for children who experienced complications was 2 years. The most common FB removal technique was laryngoscopy and bronchoscopy. In majority of the cases, children were treated by ENT department. The most common FBs were nuts, seeds, berries, corn and beans. In general, small, round crunchy foods pose a risk of choking. Since prevention is the most essential key to deal with these types of injuries, more effort in caregivers' public education is warranted.

Predicting severity of foreign body injuries in children in upper airways: an approach based on regression trees.

The entry of a small item into the upper airways is one of the leading causes of injuries in children up to 14 years old. The aim of this study is to characterize types of objects causing choking along with the features of the children involved in the accident and compare results with current standards. The European Survey on Foreign Bodies Injuries Study (ESFBI) collected data on foreign body injuries from 19 European countries. The data from ESFBI were selected according to the ICD-9-CM codes 933 (foreign body in the pharynx and larynx) and 934 (foreign body in the trachea, bronchi, and lungs). Both a classification tree and a linear discriminant analysis (LDA) have been set up to predict the probability that an injured child experiences a hospitalization. The classification tree provides flowchart-type decision rules and allows for analyzing the impact of the item features, the children characteristics, and the circumstances of the accidents on the severity of the foreign body injuries. Results showed that children younger than 3.5 who are involved in an accident have a high probability to experience a hospitalization.