Incidence, Mortality, and Cost Burden of Patients Admitted With Foreign Body Aspiration in the United States

Abstract

Foreign body aspiration (FBA) can be a potentially life-threatening event. It accounts for thousands of emergency room visits and hospital admissions each year in the United States. Though most of these events are nonfatal it causes significant morbidity and contributes to considerable health care expenditure. Unfortunately, nationwide studies, especially pertaining to the adult population, are lacking since current data predominantly is derived from single-center studies. The objective of this study is to describe both adult and children epidemiology of FBA in a nationwide analysis. METHODS: Retrospective cohort study using the National Inpatient Sample (NIS) database to determine the frequency of admissions, procedural interventions performed, in-hospital mortality rate, length-of-stay (LOS) and hospitalization costs for patients admitted with FBA between 1/1/2012 to 12/31/2014. NIS is the largest all-payer public inpatient care database, representing an approximate stratified 20% sample of all non-Federal, short-term, general, and specialty hospitals in the United States, including data on more than seven million hospital stays. RESULTS: A total of 18,030 patients were admitted with a primary diagnosis of FBA over the three-year period, mean age: 51.9 years (CI: 50.4-53.3), Caucasians: 63.4%, female: 48.4%. Overall, foreign bodies in the trachea or bronchus accounted for 10,265 patients (56.9%). The remaining FBAs were located in the pharynx or larynx. There were 1,590 laryngoscopies and tracheoscopies performed and 3,165 bronchoscopies for a total of 4,755 diagnostic procedures. Foreign body retrieval was achieved in 90% (4,295) of cases. The hospital mortality rate was 1,375 (7.6%). Patients <18 years old had a mortality rate of 1.4% compared to adults who had a mortality of 9.6%. The mean length of stay was 3.9 days (CI: 3.7-4.1). The mean charges and actual costs per case