Predictors for operative intervention in adult patients with foreign body ingestion
Abstract
BACKGROUND
The management of foreign body ingestion in the adult population varies widely given the lack of evidence-based guidelines. The purpose of this study was to identify risk factors associated with the need for operative intervention in these cases.
METHODS
This was a retrospective cohort study between July 2015-January 2021. All adult patients (age ≥18 years) presenting after foreign body ingestion were included. We collected and analyzed demographics and clinical outcomes data. Multivariable regression was utilized to identify foreign body characteristics associated with operative interventions.
RESULTS
A total of 303 patient encounters were included. Ingested foreign bodies were classified as sharp/pointed (64.7%), blunt (40.6%), magnetic (8.3%), or corrosive/battery (5.0%). Forty percent underwent endoscopic interventions, including esophagogastroduodenoscopy (35.3%), and colonoscopy (4.6%). Twelve (4.0%) patients underwent an operative intervention secondary to perforation or failure to progress. Patients with perforation or failure to progress had longer median foreign body lengths compared to patients without these complications (11.5cm vs. 3.0cm, p<0.001). On multivariate regression analysis, foreign body length was significantly associated with the need for operative intervention (odds ratio [OR]: 1.67 for each centimeter increment, p<0.001). The ingestion of sharp/pointed objects was associated with a lower risk of operative intervention (OR: 0.20, p=0.04).…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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