Buttazzoni Elisa, Gregori Dario, Paoli Bibiana, Soriani Nicola, Baldas Solidea, Rodriguez Hugo, Lorenzoni Giulia
Department of Pediatrics, San Daniele del Friuli Hospital, Udine, Italy.
Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
Int J Pediatr Otorhinolaryngol. 2015 Dec;79(12):2200-7. doi: 10.1016/j.ijporl.2015.10.003. Epub 2015 Oct 22.
To provide an epidemiological framework of symptoms related to Foreign Body (FB) injuries due to Button Battery (BB).
Data on BB ingestion/inhalation have been obtained from the ButtonBatteryDB. The ButtonBatteryDB is a database collecting information on BB injuries in children (0-18 years of age). Data on 348 BB injures have been derived from the Registry of Foreign Body Injuries "Susy Safe" (269 cases) and from published scientific literature reporting case reports of FB injuries (79 cases).
Most of injured children were male and BBs were found more often in the mouth/esophagus/stomach (ICD935) and in the nose (ICD932). Analyzing symptoms related to BB located in the esophagus/mouth/stomach, we found that children had higher probability of experiencing dysphagia (30.19%, 95% C.I. 17.83-42.55), fever and cough (26.42%, 95% C.I. 14.55-38.28), compared to the other symptoms. Referring to the probability that symptoms occurred simultaneously, fever and cough are more likely (3.72%, 95% C.I. 1.0-6-43) to jointly showing up in children with BB in mouth/esophagus/stomach (ICD935), followed by fever and dysphagia (2.66%, 95% C.I. 0.36-4.96) and by fever and irritability/crying, fever and drooling, dysphagia and irritability/crying (2.13% C.I. 0.00-4.19, 95% C.I.)
These findings provide new insight in clinical presentation of BB injuries: the identification of unique patterns of symptoms related to BB injuries is useful to perform an early diagnosis (and to guarantee a prompt medical reaction), also when the injury is un-witnessed.
提供一个与纽扣电池(BB)导致的异物(FB)损伤相关症状的流行病学框架。
纽扣电池摄入/吸入的数据来自纽扣电池数据库(ButtonBatteryDB)。纽扣电池数据库是一个收集儿童(0至18岁)纽扣电池损伤信息的数据库。348例纽扣电池损伤的数据来自异物损伤登记处“苏西安全”(Susy Safe)(269例)以及发表的报告异物损伤病例报告的科学文献(79例)。
大多数受伤儿童为男性,纽扣电池在口腔/食管/胃(国际疾病分类第九版[ICD935])和鼻腔(ICD932)中更常见。分析与位于食管/口腔/胃的纽扣电池相关的症状时,我们发现与其他症状相比,儿童出现吞咽困难(30.19%,95%置信区间17.83 - 42.55)、发热和咳嗽(26.42%,95%置信区间14.55 - 38.28)的可能性更高。就症状同时出现的概率而言,发热和咳嗽更有可能(3.72%,95%置信区间1.0 - 6.43)在口腔/食管/胃中有纽扣电池的儿童(ICD935)中同时出现,其次是发热和吞咽困难(2.66%,95%置信区间0.36 - 4.96)以及发热和易怒/哭闹、发热和流口水、吞咽困难和易怒/哭闹(2.13%,置信区间0.00 - 4.19,95%置信区间)。
这些发现为纽扣电池损伤的临床表现提供了新的见解:识别与纽扣电池损伤相关的独特症状模式有助于进行早期诊断(并确保及时的医疗反应),即使损伤情况无人目睹。