Risk factors for lower respiratory tract infection in children with tracheobronchial foreign body aspiration

Abstract The aim of this study was to determine the risk factors for lower respiratory tract infection (LRTI) in children caused by tracheobronchial foreign body aspiration (TFBA). A total of 351 patients were retrospectively reviewed; all patients were diagnosed with TFBA at West China Hospital of Sichuan University from 2015 to 2017. Univariate analyses and multivariate analysis were used. Age (<2 years) (P < .001), type of foreign body (plant) (P < .001), shape of foreign body (nonsmooth) (P < .001), and residence time of foreign body (>7 days) (P = .001) were risk factors for LRTI on univariate analysis. Multivariate analysis showed age (<2 years) (hazard ratio [HR] = 4.457; 95% confidence interval [CI] = 2.031–6.884; P < .001), type of foreign body (plant) (HR = 2.686; 95% CI = 1.577–3.452; P < .001), shape of foreign body (nonsmooth) (HR = 1.649; 95% CI = 1.437–3.663; P < .008), and residence time of foreign body (>7 days) (HR = 1.751; 95% CI = 1.329–3.554; P = .004) were independent risk factors for LRTI. Furthermore, children with LRTI also had longer lengths of hospital stays and antibiotic use than did children without LRTI. Age, plant foreign body, nonsmooth foreign body, and long-term incarceration were all independent risk factors for LRTI in children. These results can help us to select more appropriate intervention times and stratified treatment for children with TFBA.

[1]  Lan Jiang,et al.  Correlative factors for the location of tracheobronchial foreign bodies in infants and children. , 2018, Journal of thoracic disease.

[2]  M. Witmans,et al.  A simple management option for chronically impacted sharp tracheobronchial foreign bodies in children , 2018, Journal of Otolaryngology - Head & Neck Surgery.

[3]  S. Woo,et al.  Tracheobronchial foreign body removal in infants who had very small airways: A prospective clinical trial , 2018, The clinical respiratory journal.

[4]  Sara Saeed,et al.  Tracheobronchial Foreign Bodies in Children: The Role of Emergency Rigid Bronchoscopy , 2017, Global pediatric health.

[5]  D. Avlan,et al.  A Diagnostic Dilemma for the Pediatrician: Radiolucent Tracheobronchial Foreign Body. , 2017, Pediatrics and neonatology.

[6]  A. V. van As,et al.  Review of tracheobronchial foreign body aspiration in the South African paediatric age group. , 2016, Journal of thoracic disease.

[7]  Y. Aydin,et al.  Foreign Bodies in Trachea: A 25-years of Experience. , 2016, The Eurasian journal of medicine.

[8]  L. Gvozdenović,et al.  Tracheobronchial Foreign Bodies in Infants in Serbia: Five-Year Study. , 2016, Pediatric emergency care.

[9]  Yi Yang,et al.  Risk factors for preoperative respiratory complications in children with tracheobronchial foreign bodies , 2016, The Journal of international medical research.

[10]  Lisheng Xie,et al.  Risk factors for granuloma formation in children induced by tracheobronchial foreign bodies. , 2015, International journal of pediatric otorhinolaryngology.

[11]  A. Heidarzadeh,et al.  Tracheobronchial Foreign-Bodies in Children; A 7 Year Retrospective Study , 2015, Iranian journal of otorhinolaryngology.

[12]  Huanan Luo,et al.  Tracheobronchial foreign bodies in children – a retrospective study of 2,000 cases in Northwestern China , 2015, Therapeutics and clinical risk management.

[13]  Wenxian Li,et al.  A Time Series Observation of Chinese Children Undergoing Rigid Bronchoscopy for an Inhaled Foreign Body: 3149 Cases in 1991–2010 , 2015, Chinese medical journal.

[14]  Y. Maru,et al.  Role of virtual bronchoscopy in children with a vegetable foreign body in the tracheobronchial tree , 2014, The Journal of Laryngology &#x0026; Otology.

[15]  Lianjun Lin,et al.  The clinical features of foreign body aspiration into the lower airway in geriatric patients , 2014, Clinical interventions in aging.

[16]  M. S. Mallick.  Tracheobronchial foreign body aspiration in children: A continuing diagnostic challenge , 2014, African journal of paediatric surgery : AJPS.

[17]  Harpal Singh,et al.  Tracheobronchial Foreign Body Aspiration in Children , 2014, Clinical pediatrics.

[18]  A. Dilek,et al.  A dose study of remifentanil in combination with propofol during tracheobronchial foreign body removal in children. , 2013, Journal of clinical anesthesia.

[19]  Yong-Tian Lu,et al.  Similarities and differences in aspirated tracheobronchial foreign bodies in patients under the age of 3 years. , 2012, International journal of pediatric otorhinolaryngology.

[20]  W. Wen,et al.  Removal of Tracheobronchial Foreign Bodies via Suspension Laryngoscope and Hopkins Telescope in Infants , 2011, The Annals of otology, rhinology, and laryngology.

[21]  J. Gilyoma,et al.  Endoscopic procedures for removal of foreign bodies of the aerodigestive tract: The Bugando Medical Centre experience , 2011, BMC ear, nose, and throat disorders.

[22]  B. Bokare,et al.  Management of Tracheobronchial Foreign Bodies: A Retrospective and Prospective Study , 2011, Indian Journal of Otolaryngology and Head & Neck Surgery.

[23]  J. Akpeh,et al.  Tracheobronchial foreign body aspiration in children: how reliable are clinical and radiological signs in the diagnosis? , 2010, Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery.

[24]  K. Mehta,et al.  Foreign body in tracheobronchial tree , 2007, Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India.

[25]  F. Rahim,et al.  Foreign body aspirations in Infancy: a 20-year experience , 2009, International journal of medical sciences.

[26]  C. Chiles,et al.  Tracheobronchial Foreign Body Aspiration in Adults , 2009, Southern medical journal.

[27]  B. Liu,et al.  EMLA® Cream coated on the rigid bronchoscope for tracheobronchial foreign body removal in children , 2009, The Laryngoscope.

[28]  C. Zhijun,et al.  Therapeutic experience from 1428 patients with pediatric tracheobronchial foreign body. , 2008, Journal of pediatric surgery.

[29]  S. Turedi,et al.  An unusual tracheobronchial foreign body , 2008, Emergency Medicine Journal.

[30]  S. Janković,et al.  Removal of tracheobronchial foreign bodies in adults using flexible bronchoscopy: experience 1995–2006 , 2008, Surgical Endoscopy.

[31]  A. Cataneo,et al.  Management of tracheobronchial foreign body in children , 2008, Pediatric Surgery International.

[32]  Šekib Umihanić,et al.  Tracheobronchial foreign bodies in children. Experience at ORL clinic Tuzla, 1954-2004. , 2007, International journal of pediatric otorhinolaryngology.

[33]  R. Memon,et al.  Foreign body in tracheobronchial tree , 2007, Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India.

[34]  S. Kaya,et al.  The Relationship between Time of Admittance and Complications in Paediatric Tracheobronchial Foreign Body Aspiration , 2005, Acta chirurgica Belgica.

[35]  E. Friedman.  Tracheobronchial foreign bodies. , 2000, Otolaryngologic clinics of North America.