TY - JOUR
T1 - Bronchoscopy for Pediatric Airway Foreign Body
T2 - Thirty-Day Adverse Outcomes in the ACS NSQIP-P
AU - Tan, Grace X.
AU - Boss, Emily F.
AU - Rhee, Daniel S.
N1 - Publisher Copyright:
© American Academy of Otolaryngology–Head and Neck Surgery Foundation 2018.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - 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.
AB - 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.
KW - NSQIP
KW - adverse events
KW - bronchoscopy
KW - outcomes
KW - pediatric foreign body aspiration
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U2 - 10.1177/0194599818800470
DO - 10.1177/0194599818800470
M3 - Article
C2 - 30226798
AN - SCOPUS:85061175200
SN - 0194-5998
VL - 160
SP - 326
EP - 331
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 2
ER -