The characteristics of occult foreign body aspiration and predicting factors in children

Objective

To summarize the clinical characteristics and risk factors of occult foreign body aspiration (FBA) in children, which can help with early diagnosis and timely intervention, potentially preventing further exacerbations.

Methods

We retrospectively analyzed the clinical data of the children with a final diagnosis of FBA by flexible bronchoscopy in our hospital from 2017 to 2023. The patients were divided into occult and typical groups, and two groups were compared. Multivariate binary logistic regression analysis was employed to identify risk factors associated with the occurrence of occult FBA.

Results

Among 1031 patients, the incidence of occult FBA was 4.3 % (44 cases). Compared to the typical group, children in the occult group had higher odds of ventilator management (P = .006) and longer postoperative hospitalization time (P < .001). Risk factors for predicting occult FBA were identified as age greater than 3 years old [OR: 6. 918; 95%CI (3.150–15.191)], fever [OR: 2.323; 95%CI (1.092–4.939)], inspiratory laryngeal stridor [OR: 6.514; 95%CI (1.863–22.781)], atelectasis [OR: 3.372; 95%CI (1.418–8.020)], and infiltration [OR: 2.749; 95%CI (1.195–6.323)].

Conclusions

Unlike typical FBA, the diagnosis of occult FBA is far more challenging, and occult foreign bodies are linked to a further exacerbation. This study identifies a few risk factors that have the potential to facilitate an early diagnosis of occult FBA in children. Further multicenter studies should be conducted to validate the findings.