Review Finds Surprisingly High Death Rate for Kids' Choking

Airway obstruction is infrequent, but 2003 data show 3.4 percent in-hospital mortality rate
By Rick Ansorge
HealthDay Reporter

MONDAY, April 19 (HealthDay News) -- Hospital admissions for airway foreign body and esophageal foreign body airway obstruction in pediatric patients occur infrequently, but are associated with a surprisingly high mortality rate, according to a review published in the April issue of the Archives of Otolaryngology -- Head & Neck Surgery.

Rahul K. Shah, M.D., of the George Washington University Medical Center in Washington, D.C., and colleagues analyzed 2003 data from the Kids' Inpatient Database on 2,984,129 pediatric discharges from 3,438 hospitals in 36 states.

The researchers found that 2,771 patients (59 percent male; mean age, 3.5 years) were admitted for an airway foreign body or an esophageal foreign body obstructing the airway, with average length of stay of 6.4 days and an average 2.4 procedures. Fifty-five percent of the patients were under 2 years of age, and 42 percent of the foreign bodies were classified as food. The researchers found that 71 percent of cases were treated at teaching hospitals, and that the primary procedures performed were bronchoscopy (52 percent), esophagoscopy (28 percent), and tracheotomy (1.7 percent). They also found that the rates of positive foreign body findings for bronchoscopy and esophagoscopy were 37 and 46 percent, respectively, and noted a surprisingly high in-hospital mortality rate of 3.4 percent.

"Alternative education measures should be considered to train physicians in the management of this infrequent, potentially lethal condition," the authors conclude.

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