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Interhospital transfer dynamics in foreign body aspiration: Age-stratified nationwide retrospective cohort study
Muhammed Saltuk Deniz1, Kadir Baturhan Çiflik2, Büşra Özdemir Çiflik3
1Republic of Türkiye Ministry of Health, General Directorate of Emergency Health Services, Ankara, Türkiye.
Insights
Foreign body aspiration (FBA) necessitates interhospital transfers, with age significantly impacting transfer distance and type. Pediatric and geriatric patients exhibit distinct transfer patterns, unlike adults, while transfer timing and mode remain consistent across age groups.
Area of Science:
- Emergency Medicine
- Pediatric Pulmonology
- Healthcare Logistics
Background:
- Foreign body aspiration (FBA) is a critical emergency, especially in children, often requiring specialized care unavailable locally.
- Interhospital transfers are frequently necessary for FBA patients, involving complex logistical and clinical considerations.
Purpose of the Study:
- To analyze transfer dynamics for patients with foreign body aspiration (FBA).
- To identify age-related differences in interhospital transfer characteristics for FBA cases.
Main Methods:
- A retrospective nationwide cohort study in Türkiye (2022-2024) analyzed FBA patients requiring interhospital transfer.
- Patients were categorized into pediatric (0-17), adult (≥18), and geriatric (≥65) groups.
- Key variables included transfer distance, timing, type (intra- vs. inter-provincial), and mode (ground vs. air ambulance).
Main Results:
- Pediatric patients were more often transferred out-of-province and over longer distances compared to adults.
- Geriatric patients showed higher rates of intra-provincial transfers and shorter distances than other groups, but longer distances than adults when transferred out-of-province.
- Transfer timing and mode did not significantly vary by age group.
Conclusions:
- Patient age is a significant factor influencing the type and distance of interhospital transfers for foreign body aspiration.
- Understanding these age-specific transfer dynamics is crucial for optimizing patient management and resource allocation in FBA cases.
Background:
Foreign body aspiration (FBA) is an acute clinical emergency that is particularly common in the pediatric population and, if not managed promptly, can lead to serious morbidity and mortality across all age groups. The need for bronchoscopy, intensive care capabilities, and experienced teams often makes interhospital transfer unavoidable. This study aimed to evaluate the transfer dynamics of patients transferred due to FBA and to identify potential differences among age groups.
Methods:
In this retrospective cohort nationwide study, patients who underwent interhospital transfer due to FBA across Türkiye between 2022 and 2024 were included. Patients were stratified into three age groups: Pediatric (0-17 years), adult (≥18 years), and geriatric (≥65 years). The primary variables analyzed included transfer distance, transfer timing (working hours vs. off-hours), transfer type (intra-provincial vs. inter-provincial), and transfer mode (ground vs. air ambulance).
Results:
A total of 2.816 patients were analyzed, including 1.135 (40.3%) females and 1.681 (59.7%) males. The median age was three years (12, 0-97). Pediatric patients were more frequently transferred to out-of-province centers compared to adults (odds ratio [OR] 1.90; 95% confidenve interval [Cl]: 1.44-2.52; p<0.001) and had significantly longer transfer distances (p<0.001). In comparisons with other age groups, geriatric patients had higher rates of intra-provincial transfers (OR =1.65; 95% Cl: 1.08-2.51; p=0.013) and shorter transfer distances (p=0.010). However, when directly compared with pediatric patients, geriatric patients were more frequently transferred out of province (OR 1.74; 95% GA: 1.18-2.57; p=0.006) and over longer di stances (p=0.004).
Conclusion:
Age groups have a significant impact on the type and distance of interhospital transfers in FBA cases. In contrast, the timing of transfer and mode of transportation do not differ significantly by age.
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