Foreign Body Aspiration Complicated by Pneumothorax in Children: HCUP-KID Perspective

Area of Science:

• Pediatric Pulmonology
• Thoracic Surgery
• Healthcare Informatics

Background:

• Airway foreign bodies (AFB) are a common pediatric emergency.
• Pneumothorax is a serious complication of pediatric AFB.
• Understanding the impact of pneumothorax on clinical course is crucial for patient management.

Purpose of the Study:

• To compare the clinical course of children with airway foreign bodies (AFB) who develop pneumothorax versus those who do not.
• To identify differences in outcomes, including length of stay, charges, and mortality, based on the presence and timing of pneumothorax.

Main Methods:

• Retrospective analysis of the 2016 Kids' Inpatient Database.
• Identification of pediatric patients with AFB using ICD-10 code T17XXXX.
• Grouping patients into preoperative pneumothorax, postoperative pneumothorax, or no pneumothorax cohorts for comparative analysis.

Main Results:

• A total of 4165 children with AFB were analyzed; 1.8% had preoperative pneumothorax and 0.7% had postoperative pneumothorax.
• Patients with preoperative pneumothorax were older and experienced significantly longer lengths of stay (37.7 days) and higher total charges ($939K).
• The mortality rate was substantially higher in the preoperative pneumothorax group (16%) compared to those without pneumothorax (3.7%).

Conclusions:

• Pneumothorax significantly complicates the hospital course for children with airway foreign bodies.
• The presence of preoperative pneumothorax is a critical indicator of increased mortality risk.
• Early recognition and management of pneumothorax in pediatric AFB cases are essential.