Inpatient Pediatric Foreign Body Ingestion: National Estimates and Resource Utilization

We generated national estimates of patient and hospitalization characteristics for pediatric inpatient admissions for foreign body ingestion (FBI) and compared these to admissions for other reasons. We further identified characteristics that were independently associated with length of stay (LOS). Finally, we hypothesized that endoscopy within 24 hours of admission was independently associated with a shorter LOS in patients admitted for FBI.

In this retrospective study, we used data from the Kids' Inpatient Database for 2016. Admissions for FBI were identified and national estimates of patient and hospitalization characteristics were generated. Patients admitted for FBI were compared to patients admitted for other causes. Data were analyzed for independent associations with LOS. Subgroup analysis was performed to determine whether early endoscopy was associated with a shorter LOS.

A total of 2464 admissions for FBI were identified in the database. The median (interquartile range) patient age was 4 (1-11) years with a slight male predominance. Most patients (82.6%) had an endoscopy performed during admission. Independent factors associated with increased LOS included: airway procedures, intra-abdominal surgery, psychiatric diagnosis, esophageal disorder, and developmental delay. Among patients who required endoscopy, 56.7% were performed early (within 24 hours). Early endoscopy was independently associated with a 35% shorter LOS (incidence rate ratio = 0.65, 95% confidence interval 0.54-0.80; P=0.009).

Inpatient admissions for FBI frequently require endoscopy and have a short LOS. In patients who require endoscopy during the admission, early endoscopy (within 24 hours of admission) may be associated with a shorter LOS.