Resource utilization patterns of pediatric esophageal foreign bodies

Laura F. Teisch, Jun Tashiro, Eduardo Perez, Fernando Mendoza, Juan E Sola

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Ingested foreign bodies are a frequent presentation in pediatric emergency departments. Although some pass spontaneously through the gastrointestinal tract, the majority of esophageal-ingested foreign bodies (EFB) require removal. Materials and Methods Kids' Inpatient Database (1997-2009) was used to identify children (aged <20 y) with EFB (International Classification of Diseases, Ninth Revision, Clinical Modification code 935.1). Multivariate logistic regression analyses were constructed to identify predictors of resource utilization. Results Overall, 14,767 EFB cases were identified. Most patients were <5 y of age (72%), boys (57%), and non-Caucasian (55%), with a median (interquartile range) length of stay (LOS) of 1 (1) d, and total charges of $11,003 (8503). A total of 11,180 procedures were performed, most commonly esophagoscopy (77%), followed by bronchoscopy (20%), gastroscopy (2%), and rarely surgery (0.8%). By multivariate logistic regression, increased total charges were associated with a diagnosis of esophageal ulceration (odds ratio [OR] = 1.57), esophagoscopy (OR = 1.42), and bronchoscopy (OR = 1.62), all P < 0.001. Total charges also increased with admission to urban nonteaching hospitals (OR = 1.51) versus urban teaching hospitals, P < 0.001. Prolonged LOS (≥1 d) was associated with admission to a hospital in the Midwest (OR = 3.18) and with esophageal ulceration (OR = 2.11) and esophagoscopy (OR = 1.13), P < 0.03. Boys had higher odds of longer hospitalization (OR = 1.21), P < 0.001. Overall hospital mortality was 0.1% (n = 16). Conclusions Most EFB occur in children <5 y of age. Esophageal ulceration, esophagoscopy, and bronchoscopy are associated with increased total charges. Esophageal ulceration, esophagoscopy, and boys are associated with an increased LOS. Surgery and hospital mortality are both extremely rare in children with EFB.

Original languageEnglish (US)
Pages (from-to)299-304
Number of pages6
JournalJournal of Surgical Research
Volume198
Issue number2
DOIs
StatePublished - Oct 1 2015

Fingerprint

Foreign Bodies
Esophagoscopy
Odds Ratio
Pediatrics
Bronchoscopy
Length of Stay
Urban Hospitals
Hospital Mortality
Logistic Models
Gastroscopy
International Classification of Diseases
Teaching Hospitals
Gastrointestinal Tract
Hospital Emergency Service
Inpatients
Hospitalization
Regression Analysis
Databases

Keywords

  • Foreign bodies
  • Health resources

ASJC Scopus subject areas

  • Surgery

Cite this

Resource utilization patterns of pediatric esophageal foreign bodies. / Teisch, Laura F.; Tashiro, Jun; Perez, Eduardo; Mendoza, Fernando; Sola, Juan E.

In: Journal of Surgical Research, Vol. 198, No. 2, 01.10.2015, p. 299-304.

Research output: Contribution to journalArticle

Teisch, Laura F. ; Tashiro, Jun ; Perez, Eduardo ; Mendoza, Fernando ; Sola, Juan E. / Resource utilization patterns of pediatric esophageal foreign bodies. In: Journal of Surgical Research. 2015 ; Vol. 198, No. 2. pp. 299-304.
@article{19f19efe31774cab87311bb990278c05,
title = "Resource utilization patterns of pediatric esophageal foreign bodies",
abstract = "Background Ingested foreign bodies are a frequent presentation in pediatric emergency departments. Although some pass spontaneously through the gastrointestinal tract, the majority of esophageal-ingested foreign bodies (EFB) require removal. Materials and Methods Kids' Inpatient Database (1997-2009) was used to identify children (aged <20 y) with EFB (International Classification of Diseases, Ninth Revision, Clinical Modification code 935.1). Multivariate logistic regression analyses were constructed to identify predictors of resource utilization. Results Overall, 14,767 EFB cases were identified. Most patients were <5 y of age (72{\%}), boys (57{\%}), and non-Caucasian (55{\%}), with a median (interquartile range) length of stay (LOS) of 1 (1) d, and total charges of $11,003 (8503). A total of 11,180 procedures were performed, most commonly esophagoscopy (77{\%}), followed by bronchoscopy (20{\%}), gastroscopy (2{\%}), and rarely surgery (0.8{\%}). By multivariate logistic regression, increased total charges were associated with a diagnosis of esophageal ulceration (odds ratio [OR] = 1.57), esophagoscopy (OR = 1.42), and bronchoscopy (OR = 1.62), all P < 0.001. Total charges also increased with admission to urban nonteaching hospitals (OR = 1.51) versus urban teaching hospitals, P < 0.001. Prolonged LOS (≥1 d) was associated with admission to a hospital in the Midwest (OR = 3.18) and with esophageal ulceration (OR = 2.11) and esophagoscopy (OR = 1.13), P < 0.03. Boys had higher odds of longer hospitalization (OR = 1.21), P < 0.001. Overall hospital mortality was 0.1{\%} (n = 16). Conclusions Most EFB occur in children <5 y of age. Esophageal ulceration, esophagoscopy, and bronchoscopy are associated with increased total charges. Esophageal ulceration, esophagoscopy, and boys are associated with an increased LOS. Surgery and hospital mortality are both extremely rare in children with EFB.",
keywords = "Foreign bodies, Health resources",
author = "Teisch, {Laura F.} and Jun Tashiro and Eduardo Perez and Fernando Mendoza and Sola, {Juan E}",
year = "2015",
month = "10",
day = "1",
doi = "10.1016/j.jss.2015.03.055",
language = "English (US)",
volume = "198",
pages = "299--304",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Resource utilization patterns of pediatric esophageal foreign bodies

AU - Teisch, Laura F.

AU - Tashiro, Jun

AU - Perez, Eduardo

AU - Mendoza, Fernando

AU - Sola, Juan E

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Background Ingested foreign bodies are a frequent presentation in pediatric emergency departments. Although some pass spontaneously through the gastrointestinal tract, the majority of esophageal-ingested foreign bodies (EFB) require removal. Materials and Methods Kids' Inpatient Database (1997-2009) was used to identify children (aged <20 y) with EFB (International Classification of Diseases, Ninth Revision, Clinical Modification code 935.1). Multivariate logistic regression analyses were constructed to identify predictors of resource utilization. Results Overall, 14,767 EFB cases were identified. Most patients were <5 y of age (72%), boys (57%), and non-Caucasian (55%), with a median (interquartile range) length of stay (LOS) of 1 (1) d, and total charges of $11,003 (8503). A total of 11,180 procedures were performed, most commonly esophagoscopy (77%), followed by bronchoscopy (20%), gastroscopy (2%), and rarely surgery (0.8%). By multivariate logistic regression, increased total charges were associated with a diagnosis of esophageal ulceration (odds ratio [OR] = 1.57), esophagoscopy (OR = 1.42), and bronchoscopy (OR = 1.62), all P < 0.001. Total charges also increased with admission to urban nonteaching hospitals (OR = 1.51) versus urban teaching hospitals, P < 0.001. Prolonged LOS (≥1 d) was associated with admission to a hospital in the Midwest (OR = 3.18) and with esophageal ulceration (OR = 2.11) and esophagoscopy (OR = 1.13), P < 0.03. Boys had higher odds of longer hospitalization (OR = 1.21), P < 0.001. Overall hospital mortality was 0.1% (n = 16). Conclusions Most EFB occur in children <5 y of age. Esophageal ulceration, esophagoscopy, and bronchoscopy are associated with increased total charges. Esophageal ulceration, esophagoscopy, and boys are associated with an increased LOS. Surgery and hospital mortality are both extremely rare in children with EFB.

AB - Background Ingested foreign bodies are a frequent presentation in pediatric emergency departments. Although some pass spontaneously through the gastrointestinal tract, the majority of esophageal-ingested foreign bodies (EFB) require removal. Materials and Methods Kids' Inpatient Database (1997-2009) was used to identify children (aged <20 y) with EFB (International Classification of Diseases, Ninth Revision, Clinical Modification code 935.1). Multivariate logistic regression analyses were constructed to identify predictors of resource utilization. Results Overall, 14,767 EFB cases were identified. Most patients were <5 y of age (72%), boys (57%), and non-Caucasian (55%), with a median (interquartile range) length of stay (LOS) of 1 (1) d, and total charges of $11,003 (8503). A total of 11,180 procedures were performed, most commonly esophagoscopy (77%), followed by bronchoscopy (20%), gastroscopy (2%), and rarely surgery (0.8%). By multivariate logistic regression, increased total charges were associated with a diagnosis of esophageal ulceration (odds ratio [OR] = 1.57), esophagoscopy (OR = 1.42), and bronchoscopy (OR = 1.62), all P < 0.001. Total charges also increased with admission to urban nonteaching hospitals (OR = 1.51) versus urban teaching hospitals, P < 0.001. Prolonged LOS (≥1 d) was associated with admission to a hospital in the Midwest (OR = 3.18) and with esophageal ulceration (OR = 2.11) and esophagoscopy (OR = 1.13), P < 0.03. Boys had higher odds of longer hospitalization (OR = 1.21), P < 0.001. Overall hospital mortality was 0.1% (n = 16). Conclusions Most EFB occur in children <5 y of age. Esophageal ulceration, esophagoscopy, and bronchoscopy are associated with increased total charges. Esophageal ulceration, esophagoscopy, and boys are associated with an increased LOS. Surgery and hospital mortality are both extremely rare in children with EFB.

KW - Foreign bodies

KW - Health resources

UR - http://www.scopus.com/inward/record.url?scp=84940723685&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84940723685&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2015.03.055

DO - 10.1016/j.jss.2015.03.055

M3 - Article

C2 - 25899146

AN - SCOPUS:84940723685

VL - 198

SP - 299

EP - 304

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 2

ER -