Clinical spectrum and outcomes of tracheobronchial foreign body aspiration in children: A retrospective cohort study

Abstract

Background

Foreign body aspiration (FBA) is one of the principal causes of respiratory emergencies in children that can be prevented. This research paper was an attempt to describe the clinical manifestation, radiographic appearance, and prognosis of tracheobronchial FBA in children and to determine which factors predict abnormal postoperative recovery.

Methods

A retrospective cohort study was conducted at Azadi Teaching Hospital, the main tertiary referral center in Kirkuk, Iraq, from January 2015 to December 2024. Medical records of 245 children (<15 years) with bronchoscopically confirmed tracheobronchial foreign bodies were reviewed. Demographic, clinical, radiological, and operative data were collected. Logistic regression was used to identify independent predictors of abnormal postoperative outcomes.

Results

The mean was 3.93 ± 3.10 years; half of them were female. The percentage of organic foreign bodies was 73.9 percent with the right main bronchus being the most common location (41.6%). There were abnormal radiology in 49.4 percent. The postoperative outcomes were full recovery (42.9%), mild cough (45.7%), respiratory distress that needed RCU observation (11.0%), and one death (0.4). Independent predictors of abnormal postoperative outcomes were abnormal radiographs (AOR = 15.22; 95% CI: 7.16–32.37; p = 0.001) and younger age. There was good model performance (AUC = 0.81).

Conclusion

The most common example of the foreign body aspiration of the tracheobronchial is in toddlers and is mostly due to organic matter. Age and abnormal chest radiographic results are the major predictors of postoperative complications in younger ages. Early identification, prompt bronchoscopy and vigorous postoperative care are pivotal to the decrease of morbidity and in particular among high-risk children. Radiographic findings during the presentation could assist in sorting out children at risk to be closely observed during the postoperative period. Raising awareness of the risks of small organic objects is crucial with the prevention in the areas of the seed ingestion.