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J Pediatr Surg ; 52(3): 410-413, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27637142

RESUMO

BACKGROUND/PURPOSE: In pediatric cases of ingested foreign bodies, gastrointestinal foreign bodies (GIFB) have distinct factors contributing to longer and more costly hospitalizations. METHODS: Patients admitted with ingested foreign bodies were identified in the Kids' Inpatient Database (1997-2009). RESULTS: Overall, 7480 cases were identified. Patients were most commonly <5years of age (44%), male (54%), and Caucasian (57%). A total of 2506 procedures were performed, GI surgical procedures (57%) most frequently, followed by GI endoscopy (24%), esophagoscopy (11%), and bronchoscopy - in cases of inhaled objects (9%). On multivariate analysis, length of stay increased when cases were associated with intestinal obstruction (OR=1.7), esophageal perforation (OR=40.0), intestinal perforation (OR=4.4), exploratory laparotomy (OR=1.9), and gastric (OR=2.9), small bowel (OR=1.5), or colon surgery (OR=2.5), all p<0.02. Higher total charges (TC) were associated with intestinal obstruction (OR=2.0), endoscopy of esophagus (OR=1.8), stomach (OR=2.1), or colon (OR=3.3), and exploratory laparotomy (OR=3.6) or surgery of stomach (OR=5.6), small bowel (OR=6.4), or colon (OR=3.4), all p<0.001. CONCLUSIONS: Surgical or endoscopic procedures are performed in approximately one third of GIFB cases. Associated psychiatric disorder or self-inflicted injury is seen in more than 20% of GIFB patients. Resource utilization is determined heavily by associated diagnoses and treatment procedures.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/economia , Corpos Estranhos/economia , Custos de Cuidados de Saúde , Broncoscopia , Criança , Pré-Escolar , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Perfuração Esofágica/economia , Perfuração Esofágica/etiologia , Esofagoscopia/economia , Esôfago , Feminino , Corpos Estranhos/complicações , Corpos Estranhos/cirurgia , Hospitalização/economia , Humanos , Obstrução Intestinal/economia , Obstrução Intestinal/etiologia , Perfuração Intestinal/economia , Perfuração Intestinal/etiologia , Tempo de Internação , Masculino , Análise Multivariada , Estudos Retrospectivos , Estômago
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