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Published on: September 11, 2018
Airway foreign bodies in pediatric patients: An analysis of composition and age via HCUP KID
Tyler Wanstreet1, Jad Ramadan2, Michele M Carr3
1School of Medicine, West Virginia University, Morgantown, WV, USA.
Insights
Airway foreign bodies (AFBs) pose significant risks, particularly non-food objects in older children. These cases involve longer hospital stays, higher charges, and increased tracheotomy rates, highlighting a serious pediatric health concern.
Area of Science:
- Pediatric Emergency Medicine
- Otolaryngology
- Public Health
Background:
- Airway foreign body (AFB) ingestion is a common pediatric emergency.
- Distinguishing between food and non-food items is crucial for understanding associated risks.
- Age-related differences in AFB outcomes require specific clinical attention.
Purpose of the Study:
- To compare outcomes for pediatric patients with food versus non-food AFBs.
- To analyze age-related differences (<2 years vs. ≥2 years) in AFB patient outcomes.
- To identify risk factors and treatment implications for pediatric AFBs.
Main Methods:
- Utilized 2016 Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) data.
- Compared outcomes (length of stay, total charge, mortality, tracheotomy) for food vs. non-food AFBs.
- Stratified analysis by age groups (<2 years vs. ≥2 years) and AFB location (larynx, trachea, bronchus).
Main Results:
- Non-food AFBs were associated with significantly older patients, longer length of stay, higher total charges, and increased tracheotomy rates compared to food AFBs.
- Patients aged ≥2 years with bronchial AFBs experienced higher total charges, longer LOS, and greater mortality risk than younger counterparts.
- Overall mortality was 3.7%, with 3.8% requiring tracheotomy.
Conclusions:
- Airway foreign bodies represent a substantial pediatric health risk.
- Non-food AFBs in older children present elevated risks and poorer outcomes.
- Age and object type are critical determinants in pediatric AFB management and prognosis.
Objective:
To compare outcomes for children food and non-food airway foreign body (AFB) diagnoses and to compare outcomes for patients age <2 versus ≥2 years with an AFB diagnosis.
Methods:
Data from 2016 HCUP KID was used to compare outcomes for food and non-food AFB diagnoses based on location in the larynx, trachea, bronchus, and whole group (including these three specified locations and location unspecified). Outcomes were also compared for children aged <2 versus ≥2 years. Demographic data included age, race, gender, primary payer, location and teaching status of the hospital. Available co-morbidity data included APR-DRG mortality and APR-DRG severity. Outcomes were length of stay (LOS), total charge, mortality, and performance of a tracheotomy.
Results:
2973 patients were included. 49.1% were less than 2 years old, the remainder (50.9%) were between 2 and 20 years old. Food AFBs made up 26.0% and 74.0% were other specified non-food AFBs. Overall mortality was 3.7%, and 3.8% underwent tracheotomy. Children with non-food AFBs were significantly older, had significantly longer median LOS, and higher median total charges, when compared to food AFBs. Non-food AFBs had a significantly higher likelihood of tracheotomy. Patients aged 2 or more years with bronchial AFBs had significantly higher total charges, LOS, and APR-DRG risk mortality and severity than <2 year old patients with bronchial AFBs.
Conclusion:
AFBs remain a serious health concern, especially non-food objects in older children which have elevated risks.
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