Geographic health disparities in the Los Angeles pediatric esophageal foreign body population

Hur, Kevin; Angajala, Varun; Maceri, Dennis R.; Hochstim, Christian

doi:10.1016/j.ijporl.2018.01.010

Cited by 7 publications

(7 citation statements)

References 25 publications

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“…Median income by zip code was collected from the American Community Survey 18 in 2019 adjusted dollars (the most recent data available) and correlated to each participant’s zip code. As in previous studies at this institution, 9 , 10 a categorical variable was created as either above or below $51 500, which was 200% of the federal poverty level (FPL) in 2019.…”

Section: Methodsmentioning

confidence: 99%

“…3,6 In the setting of specialty pediatric otolaryngology, racial/ethnic minority pediatric patients or patients from lower socioeconomic households, have been shown to have a higher prevalence of sleep disordered breathing, otitis media, esophageal foreign bodies, and neck abscesses, among other conditions. [7][8][9][10] Furthermore, despite higher prevalence of disease, these patients are less likely to undergo treatments such as adenotonsillectomy or tympanostomy tube insertion. 7,8 Several factors may contribute to healthcare access and health outcomes among such patients.…”

Section: Introductionmentioning

confidence: 99%

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Disparities in Access to Pediatric Otolaryngology Care During the COVID-19 Pandemic

Adigwu

Osterbauer

Hochstim

2021

Ann Otol Rhinol Laryngol

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Objective: Racial/ethnic minority pediatric otolaryngology patients experience health disparities, including barriers to accessing health care. Our hypothesis for this study is that Hispanic or economically disadvantaged patients would represent a larger percentage of missed appointments and report more barriers to receiving care during the COVID-19 pandemic. Methods: A cross-sectional survey utilizing a modified version of the Barriers to Care Questionnaire was administered via telephone to no-show patients, and median income by zip code was collected. Chi-squared, logistic regression, and Student’s t-tests were used to investigate any differences in those who did and did not keep their appointments as well as any differences in mean questionnaire scores. Results: No-show patients were more likely to be Hispanic than not (OR 2.3, 95% CI: 1.3, 3.9, P = .002) and to live in a zip code that had a median income less than 200% of the federal poverty level (OR 1.7, 95% CI: 1.2, 2.4, P = .004). Respondents with a high school degree tended to report more barriers to care compared to those with less education. Conclusion: In our study, we identified ethnic, financial, and logistic concerns that may contribute to patients failing to keep their appointments with the otolaryngology clinic. Future studies are needed to assess the efficacy of measures aimed to reduce these barriers to care such as preventive plans to assist new patients and expanding telehealth services.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Disparities in Access to Pediatric Otolaryngology Care During the COVID-19 Pandemic

Adigwu

Osterbauer

Hochstim

2021

Ann Otol Rhinol Laryngol

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“…Although most studies found that males were more susceptible to FB ingestion or aspiration compared with females. 4,6,7 Baram et al found a female predominance in FB aspiration cases. 8 Coins were the most common aspirated and ingested FB overall.…”

Section: Introductionmentioning

confidence: 98%

National Trends of Pediatric Aspirated/Ingested Foreign Bodies

Saw-Aung

Cipriano

2023

Clin Pediatr (Phila)

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Foreign body (FB) aspiration/ingestion in children represents a major cause of hospital admission and mortality. Evaluating risk factors and identifying trends in specific FB products could improve targeted health literacy and policy changes. A cross-sectional study querying emergency department patients less than 18 years old with a diagnosis of aspirated/ingested FB was conducted using the National Electronic Injury Surveillance System database between 2010 and 2020. Incidence rates per 100 000 people-year were calculated and multivariate analyses were performed to identify risk factors for hospital admission and mortality. There has been a significantly decreasing rate of aspirated (−23.6%; P = .013) but not ingested FB (−9.4%; P = .066) within the study period. Within pediatric aspirated FB, black compared with white patients had decreased odds of same hospital admission (odds ratio [OR]: 0.8), but increased odds of transfer admission (OR: 1.6) and mortality (OR: 9.2) (all, P < .001).

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“…oreign body ingestion is a common presentation in a pediatric emergency department setting, with coins being found in 60% to 85% of cases. 1,2 Retrieval of coins usually occurs within 24 to 48 hours by endoscopy. Coin-shaped button batteries have a similar radiographic appearance to coin currency and comprise up to 2% of pediatric foreign body ingestions.…”

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confidence: 99%

“…Foreign body ingestion is a common presentation in a pediatric emergency department setting, with coins being found in 60% to 85% of cases 1 , 2 . Retrieval of coins usually occurs within 24 to 48 hours by endoscopy.…”

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confidence: 99%

Urgency of Esophageal Foreign Body Removal: Differentiation Between Coins and Button Cell Batteries

Safavi

Brook

Sakai

et al. 2021

Otolaryngol.--head neck surg.

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Objective Coin-shaped button battery foreign bodies have a similar initial presentation to coin ingestion, but delayed retrieval of a battery from the esophagus can have devastating consequences. Variations in timing of retrieval for children with ingestion of coin foreign bodies have been reported. The study assesses the sensitivity and specificity of conventional and digital radiographs to differentiate button batteries from coin foreign bodies. Study Design 3B case control study. Study Setting Tertiary academic medical center. Methods A radiographic study of the 12 most common commercially available button batteries and 66 coins of varying international origins was performed. Foreign bodies were placed at the cervical esophagus of a cadaver, and anteroposterior (AP) and lateral conventional radiographs of the neck were obtained. Digital AP and lateral radiographs of standalone coins and batteries were also obtained. Images were blindly read by 2 otolaryngologists and 2 radiologists. Statistical analysis was performed to determine accuracy in identifying coins vs batteries. Results Using conventional radiographs to identify button batteries yielded a sensitivity of 0.88 and a specificity of 0.92 (positive predictive value [PPV] = 0.75, negative predictive value [NPV] = 0.97). Digital radiography yielded an overall sensitivity of 0.98 and specificity of 0.97 (PPV = 0.87, NPV = 0.99). Features of button batteries were only seen on AP conventional radiographs using reverse contrast. Conclusions Neither conventional nor digital radiographic imaging had perfect accuracy in identifying coins vs batteries. Features of common disc batteries were identified, which may aid in diagnosis. With potential devastating consequences from retained battery in the esophagus, emergent removal of any possible disc battery foreign body should be considered.

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Geographic health disparities in the Los Angeles pediatric esophageal foreign body population

Cited by 7 publications

References 25 publications

Disparities in Access to Pediatric Otolaryngology Care During the COVID-19 Pandemic

Disparities in Access to Pediatric Otolaryngology Care During the COVID-19 Pandemic

National Trends of Pediatric Aspirated/Ingested Foreign Bodies

Urgency of Esophageal Foreign Body Removal: Differentiation Between Coins and Button Cell Batteries

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