TY - JOUR
T1 - Cost varies with procedure type in pediatric GI foreign bodies
AU - Kennedy, Rachel S.
AU - Starker, Rebecca A.
AU - Feldman, Kelly A.
AU - Tashiro, Jun
AU - Perez, Eduardo
AU - Mendoza, Fernando G.
AU - Sola, Juan E
PY - 2016/2/11
Y1 - 2016/2/11
N2 - Background/purpose: In pediatric cases of ingested foreign bodies, gastrointestinal foreign bodies (GIFB) have distinct factors contributing to longer and more costly hospitalizations. Methods: Patients admitted with ingested foreign bodies were identified in the Kids' Inpatient Database (1997-2009). Results: Overall, 7480 cases were identified. Patients were most commonly <. 5. years of age (44%), male (54%), and Caucasian (57%). A total of 2506 procedures were performed, GI surgical procedures (57%) most frequently, followed by GI endoscopy (24%), esophagoscopy (11%), and bronchoscopy - in cases of inhaled objects (9%). On multivariate analysis, length of stay increased when cases were associated with intestinal obstruction (OR. =1.7), esophageal perforation (OR. =40.0), intestinal perforation (OR. =4.4), exploratory laparotomy (OR. =1.9), and gastric (OR. =2.9), small bowel (OR. =1.5), or colon surgery (OR. =2.5), all . p . <. 0.02. Higher total charges (TC) were associated with intestinal obstruction (OR. =2.0), endoscopy of esophagus (OR. =1.8), stomach (OR. =2.1), or colon (OR. =3.3), and exploratory laparotomy (OR. =3.6) or surgery of stomach (OR. =5.6), small bowel (OR. =6.4), or colon (OR. =3.4), all . p . <. 0.001. Conclusions: Surgical or endoscopic procedures are performed in approximately one third of GIFB cases. Associated psychiatric disorder or self-inflicted injury is seen in more than 20% of GIFB patients. Resource utilization is determined heavily by associated diagnoses and treatment procedures.
AB - Background/purpose: In pediatric cases of ingested foreign bodies, gastrointestinal foreign bodies (GIFB) have distinct factors contributing to longer and more costly hospitalizations. Methods: Patients admitted with ingested foreign bodies were identified in the Kids' Inpatient Database (1997-2009). Results: Overall, 7480 cases were identified. Patients were most commonly <. 5. years of age (44%), male (54%), and Caucasian (57%). A total of 2506 procedures were performed, GI surgical procedures (57%) most frequently, followed by GI endoscopy (24%), esophagoscopy (11%), and bronchoscopy - in cases of inhaled objects (9%). On multivariate analysis, length of stay increased when cases were associated with intestinal obstruction (OR. =1.7), esophageal perforation (OR. =40.0), intestinal perforation (OR. =4.4), exploratory laparotomy (OR. =1.9), and gastric (OR. =2.9), small bowel (OR. =1.5), or colon surgery (OR. =2.5), all . p . <. 0.02. Higher total charges (TC) were associated with intestinal obstruction (OR. =2.0), endoscopy of esophagus (OR. =1.8), stomach (OR. =2.1), or colon (OR. =3.3), and exploratory laparotomy (OR. =3.6) or surgery of stomach (OR. =5.6), small bowel (OR. =6.4), or colon (OR. =3.4), all . p . <. 0.001. Conclusions: Surgical or endoscopic procedures are performed in approximately one third of GIFB cases. Associated psychiatric disorder or self-inflicted injury is seen in more than 20% of GIFB patients. Resource utilization is determined heavily by associated diagnoses and treatment procedures.
KW - Foreign bodies
KW - Health resources
KW - Pediatrics
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U2 - 10.1016/j.jpedsurg.2016.08.015
DO - 10.1016/j.jpedsurg.2016.08.015
M3 - Article
C2 - 27637142
AN - SCOPUS:84994877266
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
ER -