Logistic regression analysis of risk factors for prolonged pulmonary recovery in children from aspirated foreign body

Int J Pediatr Otorhinolaryngol. 2013 Oct;77(10):1677-82. doi: 10.1016/j.ijporl.2013.07.024. Epub 2013 Aug 17.

Abstract

Objective: Foreign body aspiration is a life-threatening emergency for children. Fried chicken is commonly available all over the world, but no cases have previously been reported addressing this food as a tracheobronchial foreign body. We report an extremely rare case of tracheobronchial aspiration of fried chicken complicated by severe bronchitis and postoperative atelectasis. To clarify predisposing factors related to bronchopulmonary complications, we also reviewed paediatric cases of tracheobronchial foreign bodies treated in our department over the past 14 years.

Methods: We retrospectively reviewed a total of 77 cases of tracheobronchial foreign bodies from 1988 to 2011. The main outcome measure was duration of hospitalisation, reflecting postoperative therapy. Logistic regression analyses were conducted to determine risk factors for longer hospitalisation.

Results: Age, sex, and interval between the aspiration episode and bronchoscopy were not significantly associated with longer hospitalisation. Regarding kinds of foreign bodies, higher rates of longer hospitalisation were noted for patients who had aspirated peanut or animal material, as compared to patients who had aspirated non-organic material (odds ratio, 5.80; 95% confidence interval, 1.12-30.43).

Conclusions: In terms of predicting the risk of pulmonary complications, the type of foreign body aspirated offers a more meaningful factor than the interval between aspiration and operation. Specifically, peanuts or animal material containing oils appear to be associated with a more prolonged pulmonary recovery even after retrieval of the foreign body.

Keywords: Bronchoscopy; Foreign body aspiration; Fried chicken; Logistic regression analysis; Lung recovery; Odds ratio.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bronchi*
  • Bronchoscopy / methods
  • Child
  • Child, Preschool
  • Cohort Studies
  • Confidence Intervals
  • Dexamethasone / therapeutic use
  • Female
  • Follow-Up Studies
  • Foreign Bodies / complications
  • Foreign Bodies / diagnosis
  • Foreign Bodies / surgery*
  • Humans
  • Infant
  • Japan
  • Length of Stay
  • Logistic Models
  • Male
  • Odds Ratio
  • Pneumonia, Aspiration / diagnostic imaging
  • Pneumonia, Aspiration / drug therapy*
  • Pneumonia, Aspiration / etiology
  • Postoperative Care / methods
  • Pulmonary Atelectasis / diagnostic imaging*
  • Pulmonary Atelectasis / etiology
  • Pulmonary Atelectasis / physiopathology
  • Pulmonary Atelectasis / therapy
  • Retrospective Studies
  • Risk Assessment
  • Time Factors
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Dexamethasone