{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:45:58Z","timestamp":1792053958877,"version":"4.4.0"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate national mortality trends associated with choking before and after the introduction of the Heimlich maneuver in 1974.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed CDC Multiple Cause\u2010of\u2010Death data from 1970 to 2021 to identify deaths in which choking was the primary cause, using ICD\u20108, \u20109, and \u201010 codes. Deaths in which choking was coded only as a contributing cause were excluded. Mortality rates were stratified by age (15\u201364 and \u2265\u200965); for data from 1979 to 2021, deaths were additionally stratified by location (inpatient vs. outpatient) within each age stratum. Temporal trends were assessed using Joinpoint regression, with annual percentage change (APC) as the primary outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among individuals aged 15\u201364, choking mortality increased from 1970 to 1975 (APC +2.45%) then declined significantly from 1975 to 1985 (APC \u22125.15%) and continued to decrease through 2021. Outpatient deaths in this age group declined consistently from 1979 to 2021. Among adults \u2265\u200965\u2009years, no sustained mortality reduction was observed; inpatient deaths in this group fluctuated with alternating periods of increase and decrease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A sustained decline in choking\u2010related mortality among nonelderly adults coincided temporally with the introduction and widespread adoption of the Heimlich maneuver, particularly in outpatient settings. No corresponding reduction was observed among older adults in inpatient settings. These findings are consistent with a population\u2010level benefit of the maneuver in community settings, though causality cannot be established from these data. Tailored preventive strategies are needed for high\u2010risk elderly populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70767","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:31:12Z","timestamp":1785231072000},"page":"4765-4770","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends in Choking\u2010Related Deaths After Introduction of the Heimlich Maneuver"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3737-6618","authenticated-orcid":false,"given":"Christian M.","family":"Turner","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeti","family":"Gandra","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Cramer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"StatPearls","author":"Duckett S. 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Classification of Diseases Functioning and Disability \u201dJune 11 2024 https:\/\/www.cdc.gov\/nchs\/icd\/icd\u201010\u2010cm\/index.html."},{"key":"e_1_2_10_13_1","unstructured":"\u201cJoinpoint Regression Program \u201daccessed February 27 2026 https:\/\/surveillance.cancer.gov\/joinpoint\/index.html."},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2024.110198"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev\u20102013\u2010040795"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.70.1.110"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1986.03370210073024"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.70.1.113"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70767","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70767","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70767","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:09:19Z","timestamp":1792051759000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70767"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1002\/lary.70767"],"URL":"https:\/\/doi.org\/10.1002\/lary.70767","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"assertion":[{"value":"2026-03-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}