Sjogren PP et al. – This retrospective case series evaluated the outcomes of foreign body aspiration (FBA) and investigated the risk factors such as surgeon and hospital volume for a complicated course. The authors concluded that a more complicated course in children with FBA is associated with unwitnessed aspiration events and chest radiograph abnormalities. This study also identified a low number of procedures by many surgeons; however, higher complication rates were not significantly correlated with surgeon and hospital volume.

Methods

• The parameters reviewed included demographic information, surgeon, and hospital location, while the parameters recorded included mean operative time and hospital length of stay.
• The term “complicated” applied to cases requiring intensive care, hospital stay >24 hours, requirement for more than 1 bronchoscopy, operative time >1 hour, or death.

Results

• Airway foreign body extraction was performed in 450 patients aged between 0.6 and 18.8 years.
• A total of 55 surgeons performed bronchoscopy with foreign body extraction at 11 different facilities.
• For each facility, there were about 1 to 24 surgeons, which averaged to 5.4 surgeons per facility.
• Approximately 19.6% of cases were considered complicated, including 1.1% of deaths.
• Chest radiographs revealed increased rates of unwitnessed aspiration (P = .008) and hyperlucency (P<.001) or infiltrates (P = .001).
• There was no significant association between surgeon type or facility to a complicated case.