New scoring system to predict foreign body aspiration in children

To propose a new scoring system to predict foreign body aspiration (FBA) in children.

Children who underwent bronchoscopy for FBA were evaluated for age, sex, history of aspiration, physical examination, radiological findings and results of bronchoscopy retrospectively. A new proposed FBA scoring including statements about history, physical and radiological findings were applied to all patients to define a total score. The results of each statement and total FBA score were compared according to bronchoscopy findings. The sensitivity and specificity of FBA score and cut-off values of total FBA score to predict positive cases were evaluated.

Totally 720 patients with a male to female ratio of 227:133 were included. FBA was noted in 52.1% (n=375) of cases. When the scoring system compared with the existence of foreign body (FB), the patient history had no statistical significance to predict positive cases (p>0.05). The existence of FB was significantly associated with physical examination, radiological findings and total FBA score (p<0.001). The revised scoring system without history parameters had range of total scores 0 to 5. The total scores were obtained by sum of physical findings and radiological parameters and the cut-off value of 2 had the highest diagnostic performance with sensitivity and specificity of 77.9% and 74.8% to predict FBA in children.

Our results suggest that the proposed scoring system can be utilized to predict FBA in children. The total score higher than 2 is predictive for FBA. Although, physical and radiologic findings are strong parameters for positive bronchoscopy, the history of FBA has no diagnostic utility.

Level III (retrospective comparative study) STUDY TYPE: Diagnostic study.