Bronchoscopy for Pediatric Airway Foreign Body: Thirty-Day Adverse Outcomes in the ACS NSQIP-P

Grace X. Tan, Emily F. Boss, Daniel S. Rhee

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

OBJECTIVES: (1) Describe outcomes of bronchoscopy with foreign body removal among children on the basis of a large standardized multi-institutional data set. (2) Identify factors associated with 30-day adverse events.

STUDY DESIGN: Cross-sectional analysis of a US national database.

SETTING: Public data set from the ACS NSQIP-P (American College of Surgeons National Surgical Quality Improvement Program-Pediatric) from 2012 to 2015.

SUBJECTS AND METHODS: Children <18 years old who underwent bronchoscopy with removal of foreign body were identified. Patient demographics, comorbidities, hospitalization factors, surgical characteristics, and 30-day postoperative adverse events, including complication and readmission, were analyzed. Multivariate logistic regression identified predictive factors for postoperative complications and prolonged length of stay.

RESULTS: A total of 275 children underwent bronchoscopic foreign body removal (n = 165 male, 60%; n = 75 nonwhite and/or Hispanic, 27%; mean age, 3.5 years [range, 0.63-17.9; median, 2.0]). Adverse events occurred among 10 children (4%). Seven had pulmonary-related complications, and 1 patient died. Three patients were readmitted; there were no reoperations. On multivariate analysis, preoperative pulmonary disease or need for pulmonary support (odds ratio [OR], 6.42; P = .04) predicted postoperative complications. Preoperative pulmonary compromise (OR, 8.10; P < .01), American Society of Anesthesiologists class 3 or 4 (OR, 4.13; P < .01), and prolonged operative time (OR, 3.05; P = .01) were associated with prolonged hospital stay.

CONCLUSION: Bronchoscopy for retrieval of foreign body among children has an overall low incidence of 30-day adverse events. Children with preoperative pulmonary compromise have a significantly higher risk of postoperative complications. These findings may be applied to optimize perioperative care and counsel parents and families.

Original languageEnglish (US)
Pages (from-to)326-331
Number of pages6
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume160
Issue number2
DOIs
StatePublished - Feb 1 2019

Keywords

  • NSQIP
  • adverse events
  • bronchoscopy
  • outcomes
  • pediatric foreign body aspiration
  • Multivariate Analysis
  • Prognosis
  • Age Factors
  • United States
  • Humans
  • Child, Preschool
  • Infant
  • Male
  • Foreign Bodies/complications
  • Postoperative Complications/epidemiology
  • Female
  • Patient Readmission/statistics & numerical data
  • Airway Obstruction/etiology
  • Child
  • Databases, Factual
  • Length of Stay
  • Bronchoscopy/adverse effects
  • Cross-Sectional Studies
  • Risk Assessment
  • Logistic Models
  • Treatment Outcome
  • Hospitalization
  • Analysis of Variance
  • Sex Factors

PubMed: MeSH publication types

  • Journal Article

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