Foreign body ingestion in children: Definition of a nomogram to predict surgical or endoscopic intervention.

Emergency department Need for surgical or endoscopic removal Pediatric object or food ingestion Scoring system

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
14 Aug 2023
Historique:
received: 26 03 2023
revised: 28 06 2023
accepted: 11 07 2023
medline: 17 8 2023
pubmed: 17 8 2023
entrez: 16 8 2023
Statut: aheadofprint

Résumé

Foreign body ingestion (FBI) in children requires early identification to prevent adverse outcomes and may necessitate endoscopic or surgical intervention. This study aims to develop a nomogram that identifies children who require urgent surgical or endoscopic intervention by using the patient's medical history and clinical parameters collected at admission. This study is a retrospective review (01/2015-12/2020) of a multicenter case series of children admitted for FBI. Data from 5864 records from 24 hospitals in Italy were analyzed. Logistic regression models were used to establish the probability of requiring surgical or endoscopic intervention based on patient history and clinical characteristics. The nomogram representing the results from the multivariable model was reported to examine the propensity for surgery/endoscopy. The study identified a significant association between intervention and various factors, including type of foreign body (blunt: reference category, disk battery (odds ratio OR:4.89), food bolus (OR:1.88), magnets (OR:2.61), sharp-pointed (OR:1.65), unknown (OR:1.02)), pre-existing diseases or conditions (OR 3.42), drooling (OR 10.91), dysphagia (OR 5.58), vomiting (OR 3.30), retrosternal pain (OR 5.59), abdominal pain (OR 1.58), hematemesis (OR 2.82), food refusal/poor feeding (OR 2.99), and unexplained crying (OR 2.01). The multivariable regression model showed good calibration and discrimination ability, with an area under the ROC curve of 0.77. This study developed the first nomogram to predict the probability of the need for surgical or endoscopic intervention in children with FBI, based on the information collected at admission. The nomogram will aid clinicians in identifying children who require early intervention to prevent adverse outcomes.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Foreign body ingestion (FBI) in children requires early identification to prevent adverse outcomes and may necessitate endoscopic or surgical intervention. This study aims to develop a nomogram that identifies children who require urgent surgical or endoscopic intervention by using the patient's medical history and clinical parameters collected at admission.
METHODS METHODS
This study is a retrospective review (01/2015-12/2020) of a multicenter case series of children admitted for FBI. Data from 5864 records from 24 hospitals in Italy were analyzed. Logistic regression models were used to establish the probability of requiring surgical or endoscopic intervention based on patient history and clinical characteristics. The nomogram representing the results from the multivariable model was reported to examine the propensity for surgery/endoscopy.
RESULTS RESULTS
The study identified a significant association between intervention and various factors, including type of foreign body (blunt: reference category, disk battery (odds ratio OR:4.89), food bolus (OR:1.88), magnets (OR:2.61), sharp-pointed (OR:1.65), unknown (OR:1.02)), pre-existing diseases or conditions (OR 3.42), drooling (OR 10.91), dysphagia (OR 5.58), vomiting (OR 3.30), retrosternal pain (OR 5.59), abdominal pain (OR 1.58), hematemesis (OR 2.82), food refusal/poor feeding (OR 2.99), and unexplained crying (OR 2.01). The multivariable regression model showed good calibration and discrimination ability, with an area under the ROC curve of 0.77.
CONCLUSIONS CONCLUSIONS
This study developed the first nomogram to predict the probability of the need for surgical or endoscopic intervention in children with FBI, based on the information collected at admission. The nomogram will aid clinicians in identifying children who require early intervention to prevent adverse outcomes.

Identifiants

DOI: 10.1016/j.dld.2023.07.017 PMID: 37586909
pubmed: 37586909
pii: S1590-8658(23)00769-7
doi: 10.1016/j.dld.2023.07.017
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Investigateurs

Elia Mario Biganzoli (EM)
Giuseppe Marano (G)
Cristina Bucci (C)
Mariano Caldore (M)
Manuel Murciano (M)
Giulia Chiarazzo (G)
Martina Ichino (M)
Francesco Macchini (F)
Alessandra Marinari (A)
Giovanni Di Nardo (GD)
Antonio Marseglia (A)
Marco Deganello Saccomani (MD)
Debora Sala (D)
Elia Balestra (E)
Silvia Iuliano (S)

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest None.

Auteurs

Cecilia Mantegazza (C)

Pediatric Department, "Vittore Buzzi" Children's Hospital, Milan, Italy.

Simona Ferraro (S)

Center of Functional Genomics and Rare diseases Department of Pediatrics Buzzi Children's Hospital, Milan, Italy.

Davide Biganzoli (D)

Center of Functional Genomics and Rare Diseases, Buzzi Children's Hospital, Via Castelvetro 24, Milan, Italy.

Francesca Destro (F)

Department of Paediatric Surgery, Buzzi Children's Hospital, Milan, Italy.

Paolo Quitadamo (P)

Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy.

Sara Isoldi (S)

Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy; Maternal and Child Health Department, Sapienza - University of Rome, Santa Maria Goretti Hospital, Polo Pontino, Latina, Italy.

Filippo Torroni (F)

Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Monica Malamisura (M)

Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Sara Renzo (S)

Gastroenterology and Nutrition Unit, Meyer Children's Hospital, IRCCS, Florence, Italy.

Lorenzo Fioretti (L)

Gastroenterology and Nutrition Unit, Meyer Children's Hospital, IRCCS, Florence, Italy.

Paolo Gandullia (P)

Gastroenterology and Endoscopy Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.

Giacomo Tantari (G)

Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genoa, Italy.

Marta Maino (M)

Digestive Endoscopy, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.

Giorgio Fava (G)

Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Matteo Bramuzzo (M)

Pediatric Gastroenterology, Digestive Endoscopy and Clinical Nutrition Unit, Department of Pediatric, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy.

Silvia Zingarella (S)

Department of Pediatrics, Woman's and Child's University Hospital of Verona, Italy.

Maria Teresa Illiceto (MT)

Pediatric Gastroenterology and Digestive Endoscopic Unit, Department of Pediatrics, "Santo Spirito" Hospital of Pescara, Italy.

Lorenzo Norsa (L)

Pediatric Hepatology Gastroenterology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy.

Maristella Pellegrino (M)

Pediatric Surgery Unit, Maternal and Child Department, ASST GOM of Niguarda, Milan, Italy.

Luca Maria Antoniello (LM)

Pediatric Surgery Unit, Division of Women's and Children's Health, Padova University Hospital.

Paolo Orizio (P)

Department of Pediatric Surgery, Spedali Civili Children's Hospital, Brescia, Italy.

Alessio Nanni (A)

Department of Paediatrics, Marche Polytechnic University, G.Salesi Hospital, Ancona, Via Corridoni 11, 60123 Ancona, Italy.

Fabio Cisarò (F)

Digestive Endoscopy Unit, San Giovanni Battista Molinette Hospital, Azienda Ospedaliera-Universitaria, Città della Salute e della Scienza di Torino, Turin, Italy.

Enrico Felici (E)

Pediatric and Pediatric Emergency Unit, Children Hospital, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy.

Claudio Romano (C)

Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology and Pediatrics, University of Messina, Italy.

Salvatore Oliva (S)

Maternal and Child Health Department, Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Rome, Italy. Electronic address: salvatore.oliva@uniroma1.it.

Classifications MeSH