{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T16:14:19Z","timestamp":1784823259017,"version":"3.55.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Objectives:<\/jats:title>\n Pediatric foreign body aspiration (FBA) is a life-threatening emergency that may cause significant morbidity and mortality. Although bronchoscopy is the definitive diagnostic method, a considerable proportion of procedures are negative. Therefore, bronchoscopy decisions require accurate clinical and radiologic predictors.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This retrospective study included pediatric patients who underwent bronchoscopy for suspected FBA at the Kocaeli University Faculty of Medicine between January 2011 and March 2021. Demographic, clinical, and radiologic variables were analyzed. Among the 227 patients included in the study, 225 with complete clinical and radiologic data were included in the regression analyses. Univariable logistic regression was performed, and variables with\n P<\/jats:italic>\n <0.10 were entered into a forced entry multivariable model. Model performance was evaluated using ROC analysis, the Hosmer-Lemeshow calibration test, and Nagelkerke\n R<\/jats:italic>\n 2<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 227 children were included, and foreign bodies were detected in 164 patients (72.6%). Most of the removed foreign bodies were organic (87.1%). On multivariable analysis, abnormal chest radiography (OR: 4.66; 95% CI: 2.43-8.92;\n P<\/jats:italic>\n <0.001) and decreased unilateral breath sounds (OR: 2.57; 95% CI: 1.26-5.21;\n P<\/jats:italic>\n =0.009) were independent predictors of positive bronchoscopy. The model showed acceptable discrimination (AUC: 0.738; 95% CI: 0.661-0.814) and good calibration (Hosmer-Lemeshow\n P<\/jats:italic>\n =0.324). When an optimal cutoff of 0.56 was used, the sensitivity was 84.8%, and the specificity was 57.4%. A nomogram based on these predictors was constructed.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n In suspected pediatric FBA patients, abnormal chest x-rays and decreased breath sounds were identified as strong independent predictors of positive bronchoscopy. A nomogram based on these objective findings could help reduce unnecessary bronchoscopies and facilitate earlier treatment in high-risk patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/pec.0000000000003663","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T08:00:16Z","timestamp":1784707216000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Reducing Unnecessary Bronchoscopies"],"prefix":"10.1097","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3328-7381","authenticated-orcid":false,"given":"Galbinur","family":"Abdullayev","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Istinye University Medical Park Gaziosmanpa\u015fa Hospital, Istanbul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00fcseyin Fatih","family":"Sezer","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Kocaeli University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adil","family":"Avc\u0131","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Kocaeli City Hospital, Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salih","family":"Top\u00e7u","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Kocaeli University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aykut","family":"Eli\u00e7ora","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Kocaeli University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"R1-20260723","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.ijporl.2017.07.012","article-title":"The multivariate analysis of indications of rigid bronchoscopy in suspected foreign body aspiration","volume":"100","author":"Divarci","year":"2017","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"R2-20260723","doi-asserted-by":"crossref","first-page":"49","DOI":"10.4274\/jpr.galenos.2020.10692","article-title":"Diagnostic evaluation of foreign body aspiration in children","volume":"8","author":"Erdem","year":"2021","journal-title":"J Pediatr Res"},{"key":"R3-20260723","doi-asserted-by":"crossref","first-page":"136","DOI":"10.5578\/tt.68442","article-title":"Clinical approach to foreign body aspirations in children and legal results","volume":"67","author":"Sezer","year":"2019","journal-title":"Tuberk Toraks"},{"key":"R4-20260723","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1186\/s13052-021-01147-9","article-title":"A new scoring system and clinical algorithm for the management of suspected foreign body aspiration in children: a retrospective cohort study","volume":"47","author":"Fasseeh","year":"2021","journal-title":"Ital J Pediatr"},{"key":"R5-20260723","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1007\/s00405-007-0566-8","article-title":"Foreign bodies in the upper airways causing complications and requiring hospitalization in children aged 0\u201314 years: results from the ESFBI study","volume":"265","author":"Gregori","year":"2008","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"R6-20260723","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1001\/jamaoto.2021.1548","article-title":"Clinical prediction models for suspected pediatric foreign body aspiration: a systematic review and meta-analysis","volume":"147","author":"Lee","year":"2021","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"R7-20260723","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.3390\/medicina59061113","article-title":"Foreign body aspiration in children\u2014retrospective study and management novelties","volume":"59","author":"M\u00eendru","year":"2023","journal-title":"Medicina (Kaunas)"},{"key":"R8-20260723","first-page":"1206","article-title":"Rigid bronchoscopy in foreign body aspiration diagnosis and treatment in children","volume":"8","author":"Pietra\u015b","year":"2021","journal-title":"Children (Basel)"},{"key":"R9-20260723","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1179\/000349803125002959","article-title":"Foreign body aspiration in children: experience of 1160 cases","volume":"23","author":"Eren","year":"2003","journal-title":"Ann Trop Paediatr"},{"key":"R10-20260723","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3390\/tomography11020017","article-title":"Negative bronchoscopy or computed tomography radiation in children with suspected foreign body aspiration? Pros and cons","volume":"11","author":"\u00c7elikkaya","year":"2025","journal-title":"Tomography"},{"key":"R11-20260723","doi-asserted-by":"crossref","first-page":"15251","DOI":"10.1038\/s41598-024-65876-7","article-title":"A real-world study of foreign body aspiration in children with 4227 cases in Western China","volume":"14","author":"Wang","year":"2024","journal-title":"Sci Rep"},{"key":"R12-20260723","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.arcped.2022.05.006","article-title":"Delayed diagnosis of foreign body aspiration in children","volume":"29","author":"Rance","year":"2022","journal-title":"Arch Pediatr"},{"key":"R13-20260723","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.anorl.2010.12.011","article-title":"Diagnostic value of various investigations in children with suspected foreign body aspiration: review","volume":"128","author":"Hitter","year":"2011","journal-title":"Eur Ann Otorhinolaryngol Head Neck Dis"},{"key":"R14-20260723","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1177\/0194599816644410","article-title":"Predictors of foreign body aspiration in children","volume":"155","author":"Sink","year":"2016","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R15-20260723","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.crad.2004.01.006","article-title":"Tracheobronchial foreign bodies in children: importance of accurate history and plain chest radiography in delayed presentation","volume":"59","author":"Tokar","year":"2004","journal-title":"Clin Radiol"},{"key":"R16-20260723","doi-asserted-by":"crossref","first-page":"108363","DOI":"10.1016\/j.rmed.2025.108363","article-title":"Analysis of risk factors for complications of foreign body aspiration in children","volume":"248","author":"Wang","year":"2025","journal-title":"Respir Med"},{"key":"R17-20260723","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1542\/peds.2009-2862","article-title":"Prevention of choking among children","volume":"125","author":"Gardner","year":"2010","journal-title":"Pediatrics"},{"key":"R18-20260723","doi-asserted-by":"crossref","first-page":"578","DOI":"10.3389\/fped.2020.00578","article-title":"How can we do better? Learning from 617 pediatric patients with airway foreign bodies over a 2-year period in an Asian population","volume":"8","author":"Gao","year":"2020","journal-title":"Front Pediatr"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003663","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T16:00:12Z","timestamp":1784822412000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003663"}},"subtitle":["Development of a Predictive Model for Positive Bronchoscopy in Suspected Pediatric Foreign Body Aspiration"],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":18,"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000003663","relation":{},"ISSN":["0749-5161","1535-1815"],"issn-type":[{"value":"0749-5161","type":"print"},{"value":"1535-1815","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"assertion":[{"value":"2026-03-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-25","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}