From the Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; Children's Hospital of PhiladelphiaPhiladelphia, PA.
the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia Research Institute, Philadelphia, PA.
J Pediatr Gastroenterol Nutr. 2022 Sep 1;75(3):334-339. doi: 10.1097/MPG.0000000000003502. Epub 2022 Aug 9.
To review the clinical management and outcomes of magnet ingestions at a large tertiary children's hospital. To determine the association of frequency of high-powered magnet ingestion with the regulation of these magnets.
Children <18 years who presented to the emergency room and were admitted to the Children's Hospital of Philadelphia for ingestion of single or multiple magnets from January 2008 to December 2020 were included. Demographics, symptoms, management, and outcomes were analyzed. The frequency of magnet ingestion was compared over 3 eras: (1) pre-ban (2008-2012), (2) intra-ban (2013-2016), and (3) post-ban (2017-2020).
There were 167 magnet ingestions, including 99 with multiple magnets. Most patients (59%) were male and median age was 6 (interquartile range, 3-9) years. Most single magnet ingestions (86%) were discharged with outpatient monitoring, and none experienced severe outcomes. Multiple magnet ingestions led to significant morbidity including hospitalizations (68%), endoscopic procedures (48%), surgical procedures (14%), and severe outcomes (12%). Most patients (75%) were asymptomatic, however, there was a higher risk of surgery and severe complications based on the presence of symptoms ( P = 0.003). The rate of surgical intervention was higher with ≥3 magnets (31.7%) compared to 2 magnets (2.4%) ( P < 0.003). Additionally, we found an 160% increase in children with magnet ingestions in the post-ban period ( P = 0.021).
Multiple magnet ingestion is associated with high morbidity and rate of severe outcomes. There is a relationship between public policy of magnet sale and frequency of magnet ingestion.
回顾大型三级儿童医院因吞食磁铁而进行的临床管理和结果。确定高频磁铁摄入的频率与这些磁铁的监管之间的关联。
纳入 2008 年 1 月至 2020 年 12 月期间因单次或多次吞食磁铁而到费城儿童医院急诊室就诊并住院的<18 岁儿童。分析人口统计学、症状、管理和结果。比较了三个时期的磁铁摄入频率：（1）禁令前（2008-2012 年）、（2）禁令期间（2013-2016 年）和（3）禁令后（2017-2020 年）。
共有 167 例磁铁摄入，其中 99 例为多枚磁铁摄入。大多数患者（59%）为男性，中位年龄为 6 岁（四分位距 3-9 岁）。大多数单次磁铁摄入（86%）在门诊监测下出院，无严重后果。多次磁铁摄入导致显著发病率，包括住院（68%）、内镜检查（48%）、手术（14%）和严重后果（12%）。大多数患者（75%）无症状，但根据症状存在，手术和严重并发症的风险更高（P=0.003）。≥3 枚磁铁的手术干预率（31.7%）高于 2 枚磁铁（2.4%）（P<0.003）。此外，我们发现禁令后时期因磁铁摄入而住院的儿童增加了 160%（P=0.021）。
多次磁铁摄入与高发病率和严重后果发生率相关。磁铁销售的公共政策与磁铁摄入频率之间存在关系。
