New scoring system to predict foreign body aspiration in children

Özyüksel, Gül; Arslan, Ümüt; Boybeyi, Özlem; Tanyel, Feridun Cahit; Soyer, Tutku

doi:10.1016/j.jpedsurg.2019.12.015

Cited by 23 publications

(48 citation statements)

References 12 publications

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“…Rigid bronchoscopy under general anesthesia is performed in the presence of clinical and radiological findings. Different series have reported that no foreign body could be detected with rigid bronchoscopy in 16-57% of cases when applied on suspicion of FBA and the rates of positive bronchoscopy reported in the literature range from 30% to 90% (6). The current study findings in respect of the distribution of patients with FBA (51%) and without FBA (49%) were seen to be consistent with literature.…”

Section: Discussionsupporting

confidence: 89%

“…Some authors have suggested the use of CT in unconfirmed FBA cases (13)(14)(15). Some studies have suggested that the use of CT scans decreases the rate of negative bronchoscopies (6). In the current study, CT was not performed on any patient.…”

Section: Discussionmentioning

confidence: 74%

“…Radiological findings can occur both with and without a foreign body, therefore, although radiological examination is routine in FBA, it has little value in the differential diagnosis between FBA and respiratory tract infection (1). The sensitivity and specificity of chest X-rays has been reported as 62% and 57% respectively (6). Previous reports have documented normal chest x-rays in 18% to 60% of patients with FBA (1).…”

Section: Discussionmentioning

confidence: 97%

“…Although foreign body aspiration may be detected at any age, it is more common in children aged <four yearswith a predominance of male gender (6). At this age, children want to put everything into their mouth, and the neuromuscular mechanisms that separate the airway and esophagus have not yet matured [4].…”

Section: Discussionmentioning

confidence: 99%

“…Since clinical presentation, symptoms and direct X-rays were not sufficient for diagnosis, negative bronchoscopy rates have been reported in the range of 16% to 57% in the literature (18,6). Özsoylu et al detected negative bronchoscopy prevalence as 38% (12).…”

Section: Discussionmentioning

confidence: 99%

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The Danger Close to Home: Foreign body aspiration in the children, prevention, diagnosis and treatment evaluation

Karakaya

Güler

Doğan

et al. 2021

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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Objective: Foreign body aspiration (FBA) is frequently seen in children, and progresses with symptoms related to airway obstruction, leading to serious complications The aim of this study was to discuss the diagnosis and treatment principles of patients who underwent bronchoscopy for suspected foreign body aspiration, and to emphasize its preventability. Materials and Methods:A retrospective review was made of the records of patients who underwent bronchoscopy for evaluation of FBA in the Pediatric Surgery Clinics of two hospitals where the authors work from January 2017 to February 2020. Age, gender, history of FBA, clinical symptoms, chest radiography findings, bronchoscopy findings, complications, and outcome were recorded for each patient. A history of FBA, physical examination findings, and radiological study results were analyzed statistically to determine the most accurate diagnostic toolto differentiate cases with and without FBA.Results: Bronchoscopy was performed in 102 patients with suspected FBA. A foreign body was detected in 51% (52/102) of the patients. No statistically significant difference was determined in respect of age and gender. There was a statistically significant difference in respect of history and time of presentation, but no difference in terms of physical examination and radiological findings.Of the foreign bodies aspirated, 87% were nuts.No life-threatening complications occurred in any patient due to bronchoscopy. Conclusion:Nuts are the most frequently aspirated foreign bodies in childhood. History, physical examination and radiological findings may not be available for all patients. Preventive measures are important as FBA can lead to fatal consequences. Careful evaluation of the patient is necessary to reduce the negative bronchoscopy rate.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Danger Close to Home: Foreign body aspiration in the children, prevention, diagnosis and treatment evaluation

Karakaya

Güler

Doğan

et al. 2021

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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Clinical Prediction Models for Suspected Pediatric Foreign Body Aspiration

Lee

Philteos

Levin

et al. 2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCEAlthough various clinical prediction models (CPMs) have been described for diagnosing pediatric foreign body aspiration (FBA), to our knowledge, there is still no consensus regarding indications for bronchoscopy, the criterion standard for identifying airway foreign bodies.OBJECTIVE To evaluate currently available CPMs for diagnosing FBA in children.DATA SOURCES Performed in Ovid MEDLINE, Ovid Embase, PubMed, Web of Science, and CINAHL database with citation searching of retrieved studies.STUDY SELECTION Prediction model derivation and validation studies for diagnosing FBA in children were included. Exclusion criteria included adult studies; studies that included variables that were not available in routine clinical practice and outcomes for FBA were not separate or extractable.DATA EXTRACTION AND SYNTHESIS We followed the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies and the Prediction Model Risk of Bias Assessment Tool framework. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURESThe primary outcome was the diagnosis of FBA as confirmed by bronchoscopy. Characteristics of CPMs and individual predictors were evaluated. The final model presentation with available measures of performance was provided by narrative synthesis. A meta-analysis of individual predictor variables and prediction models was performed.RESULTS After screening 4233 articles, 7 studies (0.2%; 1577 patients) were included in the final analysis. There were 6 model derivation studies and 1 validation study. Air trapping (odds ratio [OR], 8.3; 95% CI, 4.4-15.5), unilateral reduced air entry (OR, 4.8; 95% CI, 3.5-6.5), witnessed choking (OR, 3.1; 95% CI, 1.0-9.6), wheezing (OR, 2.5; 95% CI, 1.2-5.2), and suspicious findings suggestive of FBA on radiography (OR, 18.5; 95% CI, 5.0-67.7) were the most commonly used predictor variables. Model performance varied, with discrimination scores (C statistic) ranging from 0.74 to 0.88. The pooled weighted C statistic score of all models was 0.86 (95% CI, 0.80-0.92). All studies were deemed to be at high risk of bias, with overfitting of models and lack of validation as the most pertinent concerns.CONCLUSIONS AND RELEVANCE This systematic review and meta-analysis suggests that existing CPMs for FBA in children are at a high risk of bias and have not been adequately validated. No current models can be recommended to guide clinical decision-making. Future CPM studies that adhere to recognized standards for development and validation are required.

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Lung ultrasound findings in children with foreign body aspiration

Aydın

Bırbılen

User

et al. 2022

J of Clinical Ultrasound

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Objectives Foreign body aspiration (FBA) has a wide clinical spectrum, patients may be asymptomatic or present with cardiopulmonary arrest. Radiological imaging methods are used in addition to history and physical examination findings for certain diagnosis. Lung ultrasonography (LUS), whose usage area is increasing year by year, can be included in these. This study aimed to investigate ultrasonography findings in FBA and hypothesized that LUS may have a standard place in FBA diagnosis. Methods Patients who administered to the pediatric emergency department between August 2019–August 2021, considered according to the clinical findings and physical examination possible FBA, and who undergone rigid bronchoscopy by pediatric surgery were included in the study. Results Thirty‐two patients were included in the study. According to the results of bronchoscopy, FBA was detected in 25 patients. The most common finding in radiography was hyperinflation on one side, while LUS findings were confluent‐B lines in eight patients, barcode‐sign in five patients, pleural line abnormalities in two patients, and pleural consolidation in two patients. Conclusion This study is the first study aiming to evaluate LUS findings in FBA to the best of our knowledge. The B‐lines, barcode sign, pleural line abnormalities and consolidation are seen findings in LUS of the patients with FBA. Although it is far from replacing chest radiography in these patients, it is possible to say that it has an equivalent value with chest radiography.

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New scoring system to predict foreign body aspiration in children

Cited by 23 publications

References 12 publications

The Danger Close to Home: Foreign body aspiration in the children, prevention, diagnosis and treatment evaluation

The Danger Close to Home: Foreign body aspiration in the children, prevention, diagnosis and treatment evaluation

Clinical Prediction Models for Suspected Pediatric Foreign Body Aspiration

Lung ultrasound findings in children with foreign body aspiration

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