{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T17:04:50Z","timestamp":1772039090903,"version":"3.50.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004071","name":"Khon Kaen University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004071","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Emerg Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Foreign body aspiration (FBA) in children is a potentially life-threatening event, especially in those under 3 years of age. This study aimed to identify clinical factors associated with hospitalization in pediatric FBA and to highlight innovative retrieval methods used in a tertiary care setting.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A retrospective analysis was conducted of pediatric patients (&lt;\u200918 years) presenting with confirmed airway FBA between January 2015 and September 2023 at Srinagarind Hospital, Khon Kaen University. Demographic information, clinical characteristics, and procedural data were collected. Univariate and multivariate logistic regression analyses identified predictors of hospitalization.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Among 297 pediatric patients with FBA, 39 (13.1%) required hospitalization. Hospitalized children were younger (median age: 3 years; interquartile range [IQR] 2\u20137) compared with non-hospitalized children (median age: 4 years; IQR 3\u20137, <jats:italic>p<\/jats:italic>\u2009=\u20090.018). FBA involving the larynx-trachea-bronchus significantly increased the likelihood of admission (adjusted odds ratio [AOR]\u2009=\u200922.0; 95% confidence interval [CI]: 6.64\u201372.63; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Delayed presentation to the emergency department more than two hours after onset was also associated with hospitalization (OR\u2009=\u20092.77; 95% CI: 1.08\u20137.09; <jats:italic>p<\/jats:italic>\u2009=\u20090.033). Although rigid bronchoscopy remained the mainstay treatment, flexible bronchoscopy was successfully utilized in nine cases. Notably, a novel technique using a 3\u00a0mm gold-plated neodymium magnet under fluoroscopic guidance enabled the safe retrieval of distal metallic foreign bodies. Complete removal of the aspirated objects was achieved in all patients; however, one patient died following prolonged hypoxia prior to hospital arrival.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Younger age, delayed emergency department presentation, and location of the foreign body in the larynx-trachea-bronchus are significant predictors of hospitalization in pediatric FBA. Rigid bronchoscopy remains the primary management strategy, while flexible bronchoscopy and innovative retrieval methods, including magnet-assisted approaches, offer effective alternatives in specific scenarios. Emphasizing early diagnosis and rapid intervention is essential to reduce complications and improve outcomes in children with FBA.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12245-025-00923-2","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T13:23:29Z","timestamp":1751376209000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical characteristics and factors influencing hospitalization in pediatric patients with foreign body aspiration: a comprehensive analysis in an emergency department"],"prefix":"10.1186","volume":"18","author":[{"given":"Piyadarat","family":"Asawasakulchokedee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1903-0907","authenticated-orcid":false,"given":"Rattapon","family":"Uppala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phanthila","family":"Sitthikarnkha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sirapoom","family":"Niamsanit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leelawadee","family":"Techasatian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suchaorn","family":"Saengnipanthkul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pornthep","family":"Kasemsiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"issue":"4","key":"923_CR1","first-page":"138","volume":"150","author":"PC Fitzpatrick","year":"1998","unstructured":"Fitzpatrick PC, Guarisco JL. Pediatric airway foreign bodies. J La State Med Soc. 1998;150(4):138\u201341.","journal-title":"J La State Med Soc."},{"issue":"6","key":"923_CR2","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1016\/j.ijporl.2012.03.002","volume":"76","author":"H Pan","year":"2012","unstructured":"Pan H, Lu Y, Shi L, Pan X, Li L, Wu Z. Similarities and differences in aspirated tracheobronchial foreign bodies in patients under the age of 3 years. Int J Pediatr Otorhinolaryngol. 2012;76(6):911\u20134.","journal-title":"Int J Pediatr Otorhinolaryngol."},{"key":"923_CR3","doi-asserted-by":"publisher","first-page":"1235308","DOI":"10.3389\/fped.2023.1235308","volume":"11","author":"Y Wu","year":"2023","unstructured":"Wu Y, Zhang X, Lin Z, Ding C, Wu Y, Chen Y, et al. Changes in the global burden of foreign body aspiration among under-5 children from 1990 to 2019. Front Pediatr. 2023;11:1235308.","journal-title":"Front Pediatr."},{"issue":"3","key":"923_CR4","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1097\/PEC.0b013e3182494eb6","volume":"28","author":"S Paksu","year":"2012","unstructured":"Paksu S, Paksu MS, Kilic M, Guner SN, Baysal K, Sancak R, et al. Foreign body aspiration in childhood: evaluation of diagnostic parameters. Pediatr Emerg Care. 2012;28(3):259\u201364.","journal-title":"Pediatr Emerg Care."},{"key":"923_CR5","doi-asserted-by":"publisher","first-page":"2299","DOI":"10.2147\/JMDH.S326967","volume":"14","author":"HM Reyad","year":"2021","unstructured":"Reyad HM, El-Deeb ME, Abbas AM, Sherief D, Elagamy OA. Foreign body aspiration in Egyptian children clinical, radiological and bronchoscopic findings. J Multidiscip Healthc. 2021;14:2299\u2013305.","journal-title":"J Multidiscip Healthc."},{"issue":"2","key":"923_CR6","first-page":"120","volume":"16","author":"M Safari","year":"2016","unstructured":"Safari M, Manesh MRH. Demographic and clinical findings in children undergoing bronchoscopy for foreign body aspiration. Ochsner J. 2016;16(2):120\u20134.","journal-title":"Ochsner J."},{"issue":"3","key":"923_CR7","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1590\/S0041-87812002000300005","volume":"57","author":"CF de Oliveira","year":"2002","unstructured":"de Oliveira CF, de Almeida JFL, Troster EJ, Vaz FAC. Complications of tracheobronchial foreign body aspiration in children: report of 5 cases and review of the literature. Rev Hosp Clin Fac Med Sao Paulo. 2002;57(3):108\u201311.","journal-title":"Rev Hosp Clin Fac Med Sao Paulo."},{"issue":"3","key":"923_CR8","doi-asserted-by":"publisher","first-page":"225","DOI":"10.4103\/0189-6725.137330","volume":"11","author":"MS Mallick","year":"2014","unstructured":"Mallick MS. Tracheobronchial foreign body aspiration in children: a continuing diagnostic challenge. Afr J Paediatr Surg. 2014;11(3):225\u20138.","journal-title":"Afr J Paediatr Surg."},{"issue":"1","key":"923_CR9","doi-asserted-by":"publisher","first-page":"5","DOI":"10.5847\/wjem.j.1920-8642.2016.01.001","volume":"7","author":"AM Salih","year":"2016","unstructured":"Salih AM, Alfaki M, Alam-Elhuda DM. Airway foreign bodies: a critical review for a common pediatric emergency. World J Emerg Med. 2016;7(1):5\u201312.","journal-title":"World J Emerg Med."},{"key":"923_CR10","doi-asserted-by":"publisher","first-page":"110198","DOI":"10.1016\/j.resuscitation.2024.110198","volume":"199","author":"T Norii","year":"2024","unstructured":"Norii T, Igarashi Y, Yoshino Y, Nakao S, Yang M, Albright D, et al. The effects of bystander interventions for foreign body airway obstruction on survival and neurological outcomes: findings of the MOCHI registry. Resuscitation. 2024;199:110198.","journal-title":"Resuscitation."},{"issue":"12","key":"923_CR11","doi-asserted-by":"publisher","first-page":"2019","DOI":"10.1016\/j.ijporl.2013.09.026","volume":"77","author":"Z Huang","year":"2013","unstructured":"Huang Z, Liu D, Zhong J, Zhou J. Delayed diagnosis and treatment of foreign body aspiration in China: the roles played by physician inexperience and lack of bronchoscopy facilities at local treatment centers. Int J Pediatr Otorhinolaryngol. 2013;77(12):2019\u201322.","journal-title":"Int J Pediatr Otorhinolaryngol."},{"issue":"3","key":"923_CR12","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1055\/s-0037-1603523","volume":"28","author":"L Haller","year":"2018","unstructured":"Haller L, Barazzone-Argiroffo C, Vidal I, Corbelli R, Anooshiravani-Dumont M, Mornand A. Safely decreasing rigid bronchoscopies for foreign-body aspiration in children: an algorithm for the emergency department. Eur J Pediatr Surg. 2018;28(3):273\u20138.","journal-title":"Eur J Pediatr Surg."},{"issue":"2","key":"923_CR13","doi-asserted-by":"publisher","first-page":"e000321","DOI":"10.1136\/wjps-2021-000321","volume":"5","author":"MA Moslehi","year":"2022","unstructured":"Moslehi MA. Failures in emergency management of pediatric airway foreign bodies by rigid bronchoscopy: we have yet to complete our learning. World J Pediatr Surg. 2022;5(2):e000321.","journal-title":"World J Pediatr Surg."},{"issue":"2","key":"923_CR14","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1016\/j.ijporl.2011.11.002","volume":"76","author":"O Cavel","year":"2012","unstructured":"Cavel O, Bergeron M, Garel L, Arcand P, Froehlich P. Questioning the legitimacy of rigid bronchoscopy as a tool for establishing the diagnosis of a bronchial foreign body. Int J Pediatr Otorhinolaryngol. 2012;76(2):194\u2013201.","journal-title":"Int J Pediatr Otorhinolaryngol."},{"issue":"4","key":"923_CR15","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","volume":"61","author":"E von Elm","year":"2008","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344\u20139.","journal-title":"J Clin Epidemiol"},{"issue":"10","key":"923_CR16","doi-asserted-by":"publisher","first-page":"e21128","DOI":"10.1016\/j.heliyon.2023.e21128","volume":"9","author":"YD Molla","year":"2023","unstructured":"Molla YD, Mekonnen DC, Beza AD, Alemu HT, Selamawi AE. Foreign body aspiration in children at University of Gondar Comprehensive Specialized Hospital, a two year retrospective study. Heliyon. 2023;9(10):e21128.","journal-title":"Heliyon."},{"issue":"6","key":"923_CR17","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.3390\/medicina59061113","volume":"59","author":"DE M\u00eendru","year":"2023","unstructured":"M\u00eendru DE, P\u0103duraru G, Rusu CD, \u021aarc\u0103 E, Azoic\u0103i AN, Ro\u0219u ST, et al. Foreign body aspiration in children-retrospective study and management novelties. Medicina (Kaunas). 2023;59(6):1113.","journal-title":"Medicina (Kaunas)."},{"issue":"4","key":"923_CR18","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1016\/j.amjsurg.2022.05.032","volume":"224","author":"AB Ulas","year":"2022","unstructured":"Ulas AB, Aydin Y, Eroglu A. Foreign body aspirations in children and adults. Am J Surg. 2022;224(4):1168\u201373.","journal-title":"Am J Surg."},{"issue":"2","key":"923_CR19","first-page":"170","volume":"3","author":"C Pyman","year":"1971","unstructured":"Pyman C. Inhaled foreign bodies in childhood. (A review of 230 cases). J Otolaryngol Soc Aust. 1971;3(2):170\u201380.","journal-title":"J Otolaryngol Soc Aust."},{"issue":"92","key":"923_CR20","first-page":"155","volume":"29","author":"HS Amer","year":"2017","unstructured":"Amer HS, El-Anwar MW, Raafat A, AlShawadfy M, Sobhy E, Ahmed SA, et al. Laryngo-tracheo-bronchial foreign bodies in children: clinical presentations and complications. Iran J Otorhinolaryngol. 2017;29(92):155\u20139.","journal-title":"Iran J Otorhinolaryngol."},{"issue":"3","key":"923_CR21","doi-asserted-by":"publisher","first-page":"E5","DOI":"10.1002\/ppul.24653","volume":"55","author":"P Goussard","year":"2020","unstructured":"Goussard P, Mfingwana L, Morrison J. Removal of distal airway foreign body with the help of fluoroscopy in a child. Pediatr Pulmonol. 2020;55(3):E5\u20137.","journal-title":"Pediatr Pulmonol."},{"issue":"6","key":"923_CR22","first-page":"e40462","volume":"15","author":"TM AlBilasi","year":"2023","unstructured":"AlBilasi TM, AlDhawi LF, AlOlaywi AN, Al Mutairy AS, AlGhamdi FR, Alamry SS, et al. Fluoroscopy-guided metallic foreign body removal: a report of three cases and literature review. Cureus. 2023;15(6):e40462.","journal-title":"Cureus."},{"issue":"12","key":"923_CR23","doi-asserted-by":"publisher","first-page":"2795","DOI":"10.1002\/lary.29523","volume":"131","author":"A Gabinet-Equihua","year":"2021","unstructured":"Gabinet-Equihua A, Cushing SL, Propst EJ, Gai N, Wolter NE. Catheter-guided basket removal of a difficult-to-reach pediatric airway foreign body. Laryngoscope. 2021;131(12):2795\u20137.","journal-title":"Laryngoscope."},{"key":"923_CR24","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/j.ijporl.2017.03.013","volume":"96","author":"X Chen","year":"2017","unstructured":"Chen X, Zhang C. Foreign body aspiration in children: focus on the impact of delayed treatment. Int J Pediatr Otorhinolaryngol. 2017;96:111\u20135.","journal-title":"Int J Pediatr Otorhinolaryngol."},{"issue":"6","key":"923_CR25","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1016\/j.arcped.2022.05.006","volume":"29","author":"A Rance","year":"2022","unstructured":"Rance A, Mittaine M, Michelet M, Martin Blondel A, Labouret G. Delayed diagnosis of foreign body aspiration in children. Arch Pediatr. 2022;29(6):424\u20138.","journal-title":"Arch Pediatr."},{"key":"923_CR26","doi-asserted-by":"publisher","first-page":"e18743064220610","DOI":"10.2174\/18743064-v16-e2206100","volume":"16","author":"HM Hemead","year":"2022","unstructured":"Hemead HM, Ramadan A, Gaafar AH, Nossier A, Abdelaziz A. Different modalities used in the art of managing tracheobronchial foreign bodies. Open Respir Med J. 2022;16:e187430642206100.","journal-title":"Open Respir Med J."},{"issue":"10","key":"923_CR27","first-page":"599","volume":"17","author":"B Mansour","year":"2015","unstructured":"Mansour B, Elias N. Foreign body aspiration in children with focus on the role of flexible bronchoscopy: a 5 year experience. Isr Med Assoc J. 2015;17(10):599\u2013603.","journal-title":"Isr Med Assoc J."},{"issue":"5","key":"923_CR28","doi-asserted-by":"publisher","first-page":"1676","DOI":"10.1164\/ajrccm.155.5.9154875","volume":"155","author":"A Martinot","year":"1997","unstructured":"Martinot A, Closset M, Marquette CH, Hue V, Deschildre A, Ramon P, et al. Indications for flexible versus rigid bronchoscopy in children with suspected foreign-body aspiration. Am J Respir Crit Care Med. 1997;155(5):1676\u20139.","journal-title":"Am J Respir Crit Care Med."},{"key":"923_CR29","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/j.resuscitation.2020.09.007","volume":"156","author":"K Couper","year":"2020","unstructured":"Couper K, Abu Hassan A, Ohri V, Patterson E, Tang HT, Bingham R, et al. Removal of foreign body airway obstruction: a systematic review of interventions. Resuscitation. 2020;156:174\u201381.","journal-title":"Resuscitation."}],"container-title":["International Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12245-025-00923-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12245-025-00923-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12245-025-00923-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T13:23:30Z","timestamp":1751376210000},"score":1,"resource":{"primary":{"URL":"https:\/\/intjem.biomedcentral.com\/articles\/10.1186\/s12245-025-00923-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["923"],"URL":"https:\/\/doi.org\/10.1186\/s12245-025-00923-2","relation":{},"ISSN":["1865-1380"],"issn-type":[{"value":"1865-1380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]},"assertion":[{"value":"5 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Khon Kaen University Ethical Committee (KKUEC), approval number HE661484, in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines. The written informed consent to participate in this study was waived by the Institutional Review Board of KKUEC as per Khon Kaen University\u2019s Announcement No. 2179\/2563, the process of obtaining subjects\u2019 consent was waive as this is a study of existing data or biological specimens without further prospective data collection from or direct interactions with the subjects.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The written inform consent for publication was obtained from the patient\u2019s legal guardian for the publication of any potentially identifiable images or data included in this article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"115"}}