Division of Gastroenterology, Department of Pediatrics.
Department of Anesthesiology, The University of Texas Health Science Center at Houston-McGovern Medical School, Houston, TX.
J Pediatr Gastroenterol Nutr. 2021 Jul 1;73(1):37-41. doi: 10.1097/MPG.0000000000003143.
We generated national estimates of patient and hospitalization characteristics for pediatric inpatient admissions for foreign body ingestion (FBI) and compared these to admissions for other reasons. We further identified characteristics that were independently associated with length of stay (LOS). Finally, we hypothesized that endoscopy within 24 hours of admission was independently associated with a shorter LOS in patients admitted for FBI.
In this retrospective study, we used data from the Kids' Inpatient Database for 2016. Admissions for FBI were identified and national estimates of patient and hospitalization characteristics were generated. Patients admitted for FBI were compared to patients admitted for other causes. Data were analyzed for independent associations with LOS. Subgroup analysis was performed to determine whether early endoscopy was associated with a shorter LOS.
A total of 2464 admissions for FBI were identified in the database. The median (interquartile range) patient age was 4 (1-11) years with a slight male predominance. Most patients (82.6%) had an endoscopy performed during admission. Independent factors associated with increased LOS included: airway procedures, intra-abdominal surgery, psychiatric diagnosis, esophageal disorder, and developmental delay. Among patients who required endoscopy, 56.7% were performed early (within 24 hours). Early endoscopy was independently associated with a 35% shorter LOS (incidence rate ratio = 0.65, 95% confidence interval 0.54-0.80; P=0.009).
Inpatient admissions for FBI frequently require endoscopy and have a short LOS. In patients who require endoscopy during the admission, early endoscopy (within 24 hours of admission) may be associated with a shorter LOS.
我们生成了儿童因异物吞食（FBI）住院的患者和住院特征的全国估计值，并将其与因其他原因住院的患者进行了比较。我们进一步确定了与住院时间（LOS）独立相关的特征。最后，我们假设在入院后 24 小时内进行内镜检查与 FBI 入院患者的 LOS 缩短独立相关。
在这项回顾性研究中，我们使用了 2016 年 Kids' Inpatient Database 的数据。确定 FBI 入院的病例，并生成患者和住院特征的全国估计值。将 FBI 入院的患者与因其他原因入院的患者进行比较。对 LOS 的独立相关因素进行数据分析。进行亚组分析以确定早期内镜检查是否与 LOS 缩短相关。
在数据库中总共确定了 2464 例 FBI 入院。患者的中位数（四分位距）年龄为 4（1-11）岁，略呈男性优势。大多数患者（82.6%）在住院期间进行了内镜检查。与 LOS 增加相关的独立因素包括：气道操作、腹内手术、精神科诊断、食管疾病和发育迟缓。在需要内镜检查的患者中，56.7%的患者在早期（入院后 24 小时内）进行了检查。早期内镜检查与 LOS 缩短 35%独立相关（发病率比=0.65，95%置信区间 0.54-0.80；P=0.009）。
因 FBI 住院的患者经常需要进行内镜检查，且 LOS 较短。在需要入院期间进行内镜检查的患者中，早期内镜检查（入院后 24 小时内）可能与 LOS 缩短相关。
