Abstract
BACKGROUND: Foreign body aspiration (FBA) in children is a critical emergency, particularly for those under 3 years old, with mortality rates as high as 4% for infants. Delayed bronchoscopy is associated with an increased rate of complications. This study evaluates whether bronchoscopy for suspected FBA in children at Odense University Hospital was performed within 24 h, as recommended. METHODS: This retrospective cohort study was conducted on children under 18 years admitted with suspected FBA from January 2018 to December 2022 at Odense University Hospital. Data were collected on demographics, symptoms, and outcomes. The primary outcome was time from aspiration event to bronchoscopy, with delays defined as procedures performed more than 24 h after the event. Secondary outcomes included complications such as pneumonia, delayed extubation, and admission to the pediatric intensive care unit. RESULTS: We identified 82 cases of children undergoing bronchoscopy in the study period. The median time to bronchoscopy was 18.8 h (IQR: 8-41), but in 30 cases (37%), the time to bronchoscopy exceeded 24 h. A foreign body was confirmed in 23 cases. Complications, including delayed extubation, pneumonia, oxygen and nebulizer treatments, and admission to the pediatric intensive care unit, occurred in 22 of all 82 cases, with a higher frequency in the delayed than the nondelayed group (37% vs. 22%). All children with confirmed FBA who underwent delayed bronchoscopy experienced complications. CONCLUSION: Between 2018 and 2022, 63% of children admitted to Odense University Hospital with suspected FBA underwent bronchoscopy within 24 h. Delays occurred in one-third of cases, primarily because FBA was not initially suspected. EDITORIAL COMMENT: This 5 year analysis of confirmed or suspected aspiration of foreign bodies at Odense University Hospital underlines the importance of timely emergency care of children. Confirmed FBA continues to have a very high morbity in children regardless of time of treatment. A "right patient, right place, right time" approach remains critical to reduce adverse events.