{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T13:30:26Z","timestamp":1781271026072,"version":"3.54.1"},"reference-count":16,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>While management protocols of pediatric esophageal foreign bodies (EFBs) are well\u2010delineated, resource utilization can be improved. This study's objectives were to explore hospital charges\/costs for pediatric patients who present with EFBs and to identify patient risk factors associated with esophageal injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review of patients undergoing aerodigestive foreign body removal at a tertiary\u2010care children's hospital from 2018 to 2021 was conducted. Data collected included demographics, medical history, presenting symptoms, EFB type, surgical findings, and hospital visit charges\/costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>203 patients were included. 178 of 203 (87.7%) patients were admitted prior to operation. Unwitnessed EFB ingestion (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, OR\u2009=\u200915.1, 95% CI\u2009=\u20095.88\u201338.6), experiencing symptoms for longer than a week (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, OR\u2009=\u200911.4, 95% CI\u2009=\u20093.66\u201338.6) and the following presenting symptoms increased the odds of esophageal injury: dysphagia (<jats:italic>p<\/jats:italic>\u2009=\u20090.04, OR\u2009=\u20092.45, 95% CI\u2009=\u20091.02\u20135.85), respiratory distress (<jats:italic>p<\/jats:italic>\u2009=\u20090.005, OR\u2009=\u200915.5, 95% CI\u2009=\u20092.09\u2013181), coughing (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, OR\u2009=\u200910.1, 95% CI\u2009=\u20093.73\u201328.2), decreased oral intake (<jats:italic>p<\/jats:italic>\u2009=\u20090.001, OR\u2009=\u20096.60, 95% CI\u2009=\u20092.49\u201317.7), fever (<jats:italic>p<\/jats:italic>\u2009=\u20090.001, OR\u2009=\u20095.52, 95% CI\u2009=\u20091.46\u201319.6), and congestion (<jats:italic>p<\/jats:italic>\u2009=\u20090.001, OR\u2009=\u20098.15, 95% CI\u2009=\u20092.42\u201327.3). None of the 51 asymptomatic patients had esophageal injury. The median total charges during the encounter was $20,808 (interquartile range: $18,636\u2013$24,252), with operating room (OR) (median: $5,396; 28.2%) and inpatient admission (median: $5,520; 26.0%) contributing the greatest percentage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Asymptomatic patients with EFBs did not experience esophageal injury. The OR and inpatient observation accounted for the greatest percentage of the hospital charges. These results support developing a potential algorithm to triage asymptomatic patients to be managed on a same\u2010day outpatient basis to improve the value of care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 134:4774\u20134782, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31479","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T11:53:33Z","timestamp":1714391613000},"page":"4774-4782","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Resource Utilization and Risk Factors for Esophageal Injury in Pediatric Esophageal Foreign Bodies"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1491-4885","authenticated-orcid":false,"given":"Basil","family":"Hashimi","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5783-9198","authenticated-orcid":false,"given":"Amber D.","family":"Shaffer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology, Department of Otolaryngology UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"McCoy","sequence":"additional","affiliation":[{"name":"Office of Research and Development Veterans Affairs Pittsburgh Healthcare System  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Chi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology, Department of Otolaryngology UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reema","family":"Padia","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology, Department of Otolaryngology University of Utah  Salt Lake City Utah U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000000729"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/children8121182"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2012.11.025"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2006.01.022"},{"issue":"2","key":"e_1_2_6_6_1","first-page":"287","article-title":"Foreign body ingestion in children","volume":"72","author":"Uyemura MC","year":"2005","journal-title":"Am Fam 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