Pediatric Bronchoscopy for Airway Foreign Bodies in the ACS NSQIP-P: Morbidity and Mortality 2014-2019

Examine morbidity and mortality associated with bronchoscopy for pediatric airway foreign body (AFB). Identify factors associated with adverse events.

A retrospective analysis from 2014 to 2019 using the multicenter public data set from the American College of Surgeons National Surgical Quality Improvement Program- Pediatric. Patients under 18 who underwent bronchoscopy for AFB were identified. Demographics, comorbidities, perioperative events, length of stay, and complications were collected. Regression analysis was used to identify factors associated with adverse events.

2302 patients were included; 1427 (62%) males and 875 (38%) females. Mean age was 3.9 years. (95% CI 3.7-4.1). 2025 (88%) retained AFB as the postoperative diagnosis. Comorbidities included structural pulmonary abnormalities in 234 (10.5%), asthma in 149 (6.5%), and impaired cognitive status in 134 (5.8%). Most common complications were pneumonia in 19 (0.8%) and reintubation in 10 (0.4%). 10 (0.4%) had a prolonged LOS >30 days. Nine (0.4%) children died within 30 days of surgery; 7 (78%) were ventilated and 6 (67%) had CPR prior to surgery. 18 (0.8%) returned to OR and 15 (0.7%) were readmitted for related reasons. Linear regression showed an association between ASA class (β = 0.708, p < 0.001), operative time (β = 0.015, p = 0.013) and reintubation (β = 10.5, p < 0.001) with LOS. Time in the OR was associated with return to OR (β = .008, p = 0.004) through logistic regression.

Morbidity is low in children with AFB and mortality is usually associated with preoperative lifesaving maneuvers.

4 Laryngoscope, 133:689-693, 2023.