Pediatric button battery ingestion : A single center experience and risk score to predict severe outcomes
Copyright © 2022 Elsevier Inc. All rights reserved..
PURPOSE: The purpose of this study was to analyze the management and outcomes of primary button battery ingestions and their sequelae at a single high-volume center, and to propose a risk score to predict the likelihood of a severe outcome.
METHODS: The medical record was queried for all patients under 21 years old evaluated at our institution for button battery ingestion from 2008 to 2021. A severe outcome was defined as having at least one of the following: deep/circumferential mucosal erosion, perforation, mediastinitis, vascular or airway injury/fistula, or development of esophageal stricture. From a selection of clinically relevant factors, logistic regression determined predictors of a severe outcome, which were incorporated into a risk model.
RESULTS: 143 patients evaluated for button battery ingestion were analyzed. 24 (17%) had a severe outcome. The independent predictors of a severe outcome in multivariate analysis were location of battery in the esophagus on imaging (96%), battery size >/ = 2 cm (95%), and presence of any symptoms on presentation (96%), with P < 0.001 in all cases. Predicted probability of a severe outcome ranged from 88% when all three risk factors were observed, to 0.3% when none were present.
CONCLUSION: We report the presentation, management, and complication profiles of a large cohort of BB ingestions treated at a single institution. A risk score to predict severe outcomes may be used by providers initially evaluating patients with button battery ingestion in order to allocate resources and expedite transfer to a center with pediatric endoscopic and surgical capabilities.
LEVEL OF EVIDENCE: Level IV.
TYPE OF STUDY: Clinical Research Paper.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:58 |
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| Enthalten in: |
Journal of pediatric surgery - 58(2023), 4 vom: 26. Apr., Seite 613-618 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Scalise, P Nina [VerfasserIn] |
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| Links: |
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| Themen: |
Foreign body ingestion |
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| Anmerkungen: |
Date Completed 20.03.2023 Date Revised 20.03.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jpedsurg.2022.12.017 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM351574204 |
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| 245 | 1 | 0 | |a Pediatric button battery ingestion |b A single center experience and risk score to predict severe outcomes |
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| 500 | |a Date Revised 20.03.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: The purpose of this study was to analyze the management and outcomes of primary button battery ingestions and their sequelae at a single high-volume center, and to propose a risk score to predict the likelihood of a severe outcome | ||
| 520 | |a METHODS: The medical record was queried for all patients under 21 years old evaluated at our institution for button battery ingestion from 2008 to 2021. A severe outcome was defined as having at least one of the following: deep/circumferential mucosal erosion, perforation, mediastinitis, vascular or airway injury/fistula, or development of esophageal stricture. From a selection of clinically relevant factors, logistic regression determined predictors of a severe outcome, which were incorporated into a risk model | ||
| 520 | |a RESULTS: 143 patients evaluated for button battery ingestion were analyzed. 24 (17%) had a severe outcome. The independent predictors of a severe outcome in multivariate analysis were location of battery in the esophagus on imaging (96%), battery size >/ = 2 cm (95%), and presence of any symptoms on presentation (96%), with P < 0.001 in all cases. Predicted probability of a severe outcome ranged from 88% when all three risk factors were observed, to 0.3% when none were present | ||
| 520 | |a CONCLUSION: We report the presentation, management, and complication profiles of a large cohort of BB ingestions treated at a single institution. A risk score to predict severe outcomes may be used by providers initially evaluating patients with button battery ingestion in order to allocate resources and expedite transfer to a center with pediatric endoscopic and surgical capabilities | ||
| 520 | |a LEVEL OF EVIDENCE: Level IV | ||
| 520 | |a TYPE OF STUDY: Clinical Research Paper | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Foreign body ingestion | |
| 650 | 4 | |a Pediatric button battery ingestion | |
| 700 | 1 | |a Durgin, Jonathan M |e verfasserin |4 aut | |
| 700 | 1 | |a Staffa, Steven J |e verfasserin |4 aut | |
| 700 | 1 | |a Wynne, Nicole |e verfasserin |4 aut | |
| 700 | 1 | |a Meisner, Jay |e verfasserin |4 aut | |
| 700 | 1 | |a Ngo, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Zendejas, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Heung Bae |e verfasserin |4 aut | |
| 700 | 1 | |a Demehri, Farokh R |e verfasserin |4 aut | |
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