Pediatric Esophageal Foreign Bodies: The Role of Socioeconomic Status in Ingestion Patterns

Abstract

ObjectivePediatric esophageal foreign bodies (EFBs) are common and can result in serious complications. Little is known about the influence of socioeconomic status (SES) on EFB ingestion in children. The goal was to study SES as a risk factor for dangerous foreign body ingestion and in‐hospital complications in children.MethodsThis was a retrospective cohort study of children presenting to a tertiary care pediatric hospital with an esophageal foreign body from 2010 to 2021. SES was assessed for each patient by linking their postal code to the Ontario Marginalization Index to determine a quintile score across four dimensions of deprivation: residential instability, material deprivation, dependency, and ethnic concentration. Dangerous EFBs were defined as magnets, batteries, sharp objects, or bones. In‐hospital complications included: intensive care unit admission, prolonged length of stay, and postoperative sequelae.ResultsA total of 680 patients were included. Dangerous EFB ingestion was higher for children with increased residential instability (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.2–3.6) and increased material deprivation (OR, 2.2; CI, 1.9–2.8), which was similarly true for odds of complications. Odds of dangerous EFB ingestion were higher in older children (OR, 1.1; CI, 1.0–1.1) and odds of complications were higher in children with comorbidities (OR, 1.1; CI, 1.0–1.3).ConclusionHigher levels of housing instability and material deprivation are associated with dangerous EFB ingestion and complications related to EFB ingestion. These findings emphasize the role that SES plays on child health outcomes and the need for initiatives to mitigate these disparities.Level of Evidence3 Laryngoscope, 2024

Current Approach to Diagnosis and Treatment of Foreign Body in Otorhinolaryngology

“…Higher levels of housing instability and material deprivation are associated with more common FB ingestion and more common complications related to FB ingestion. The odds of complications related to FB ingestion are also much higher in children with comorbidities [3].…”