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

Autor: Mantegazza C; Pediatric Department, 'Vittore Buzzi' Children's Hospital, Milan, Italy., Ferraro S; Center of Functional Genomics and Rare diseases Department of Pediatrics Buzzi Children's Hospital, Milan, Italy., Biganzoli D; Center of Functional Genomics and Rare Diseases, Buzzi Children's Hospital, Via Castelvetro 24, Milan, Italy., Destro F; Department of Paediatric Surgery, Buzzi Children's Hospital, Milan, Italy., Quitadamo P; Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy., 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., Torroni F; Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy., Malamisura M; Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy., Renzo S; Gastroenterology and Nutrition Unit, Meyer Children's Hospital, IRCCS, Florence, Italy., Fioretti L; Gastroenterology and Nutrition Unit, Meyer Children's Hospital, IRCCS, Florence, Italy., Gandullia P; Gastroenterology and Endoscopy Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy., Tantari G; Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genoa, Italy., Maino M; Digestive Endoscopy, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy., Fava G; Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Bramuzzo M; Pediatric Gastroenterology, Digestive Endoscopy and Clinical Nutrition Unit, Department of Pediatric, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy., Zingarella S; Department of Pediatrics, Woman's and Child's University Hospital of Verona, Italy., Illiceto MT; Pediatric Gastroenterology and Digestive Endoscopic Unit, Department of Pediatrics, 'Santo Spirito' Hospital of Pescara, Italy., Norsa L; Pediatric Hepatology Gastroenterology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy., Pellegrino M; Pediatric Surgery Unit, Maternal and Child Department, ASST GOM of Niguarda, Milan, Italy., Antoniello LM; Pediatric Surgery Unit, Division of Women's and Children's Health, Padova University Hospital., Orizio P; Department of Pediatric Surgery, Spedali Civili Children's Hospital, Brescia, Italy., Nanni A; Department of Paediatrics, Marche Polytechnic University, G.Salesi Hospital, Ancona, Via Corridoni 11, 60123 Ancona, Italy., Cisarò F; Digestive Endoscopy Unit, San Giovanni Battista Molinette Hospital, Azienda Ospedaliera-Universitaria, Città della Salute e della Scienza di Torino, Turin, Italy., Felici E; Pediatric and Pediatric Emergency Unit, Children Hospital, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy., Romano C; Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology and Pediatrics, University of Messina, Italy., Oliva S; Maternal and Child Health Department, Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Rome, Italy. Electronic address: salvatore.oliva@uniroma1.it.
Jazyk: angličtina
Zdroj: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2024 Feb; Vol. 56 (2), pp. 312-321. Date of Electronic Publication: 2023 Aug 14.
DOI: 10.1016/j.dld.2023.07.017
Abstrakt: Background and Aims: 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: 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: 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: 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.
Competing Interests: Conflict of interest None.
(Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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