Risk factors associated with radiolucent foreign body inhalation in adults: a 10-year retrospective cohort study
Risk factors associated with radiolucent foreign body inhalation in adults: a 10-year retrospective cohort study
Background: foreign body aspiration (FBA) is a serious condition with high morbidity and mortality rates. Although chest radiography is generally the first radiologic modality used in diagnosis, a substantial percentage of foreign bodies are radiolucent in adults with diagnosis challenging.
Methods: retrospective review of adult patients with FBA diagnosed by flexible electronic bronchoscopy from 2012 to 2022 collecting demographics, history, hospital presentation, radiographic, and operative details. Risk factors associated with radiolucent foreign body inhalation in adults were explored using appropriate statistical methods.
Results: between 1 January 2012 and 1 January 2022, 114 adult patients diagnosed with FBA were enrolled. The median age of participants was 65 years (IQR 52–74). Multidetector computed tomography (MDCT) examinations identified 28 cases (25%) showing direct visualization of the foreign body (defined as the radiopaque group) and 86 cases (75%) in the radiolucent group. Multivariable stepwise linear regression analysis showed increased odds of radiolucent foreign body inhalation in adults associated with pneumonic patches in MDCT (OR 6.99; 95% CI 1.80–27.22; P = 0.005) and plants/meat foreign bodies (OR 6.17; 95% CI 1.12–33.96; P = 0.04). A witnessed choking history (OR 0.02; 95% CI 0–0.14; P < 0.001) was a protective factor of radiolucent foreign body inhalation in adults.
Conclusions: unlike radiopaque FBA, in those presenting with a suspected radiolucent foreign body aspiration, the diagnosis is far more challenging. Risk factors such as lacking a choking history, non-resolving pneumonia (pneumonic patches) in MDCT findings, and plants/meat foreign bodies may help in the early diagnosis of radiolucent foreign body inhalation in adults. Further prospective multicenter studies should be conducted to validate the findings.
Adult, Flexible bronchoscopy, Foreign body aspiration, Multi-detector Computed Tomography (MDCT), Radiolucent, radiopaque
Liu, Xiaofan
3ab46a99-ab0b-4085-9d27-8db526a5dfc5
Ni, Fang
48cf9223-51de-4143-9203-00edd1c95c50
Guo, Tao
9c796deb-4ee0-4fc8-9f76-e0cffcb842ab
Jiang, Fangfang
26509fd0-b25c-4817-86df-075018f82444
Jiang, Yan
a0e2d928-02b3-46ce-aa3e-9dca8020956f
Song, Cheng
baa885b4-e556-45b8-9dc1-4c34e826edc5
Yuan, Mingli
09863704-7fac-49db-9be3-81585b0898f5
Tao, Zhaowu
98512cd8-7735-45b0-b737-c65fa6797cb1
Ye, Mingxin
08dfd11b-3d1a-46d5-93d3-41fe74c5085b
Xu, Junjie
061144f8-a129-43e1-8b7e-b56e1f75659d
Wang, Ying
252187b6-5482-4ab1-992c-46eab09cd2c6
Qian, Qiong
986baf65-545e-435c-a149-64d76d754133
Hu, Yi
76aec58b-254c-40e2-ba7c-7620448bb9fb
Wang, Yihua
f5044a95-60a7-42d2-87d6-5f1f789e3a7e
10 September 2022
Liu, Xiaofan
3ab46a99-ab0b-4085-9d27-8db526a5dfc5
Ni, Fang
48cf9223-51de-4143-9203-00edd1c95c50
Guo, Tao
9c796deb-4ee0-4fc8-9f76-e0cffcb842ab
Jiang, Fangfang
26509fd0-b25c-4817-86df-075018f82444
Jiang, Yan
a0e2d928-02b3-46ce-aa3e-9dca8020956f
Song, Cheng
baa885b4-e556-45b8-9dc1-4c34e826edc5
Yuan, Mingli
09863704-7fac-49db-9be3-81585b0898f5
Tao, Zhaowu
98512cd8-7735-45b0-b737-c65fa6797cb1
Ye, Mingxin
08dfd11b-3d1a-46d5-93d3-41fe74c5085b
Xu, Junjie
061144f8-a129-43e1-8b7e-b56e1f75659d
Wang, Ying
252187b6-5482-4ab1-992c-46eab09cd2c6
Qian, Qiong
986baf65-545e-435c-a149-64d76d754133
Hu, Yi
76aec58b-254c-40e2-ba7c-7620448bb9fb
Wang, Yihua
f5044a95-60a7-42d2-87d6-5f1f789e3a7e
Liu, Xiaofan, Ni, Fang, Guo, Tao, Jiang, Fangfang, Jiang, Yan, Song, Cheng, Yuan, Mingli, Tao, Zhaowu, Ye, Mingxin, Xu, Junjie, Wang, Ying, Qian, Qiong, Hu, Yi and Wang, Yihua
(2022)
Risk factors associated with radiolucent foreign body inhalation in adults: a 10-year retrospective cohort study.
Respiratory Research, 23, [238].
(doi:10.1186/s12931-022-02165-9).
Abstract
Background: foreign body aspiration (FBA) is a serious condition with high morbidity and mortality rates. Although chest radiography is generally the first radiologic modality used in diagnosis, a substantial percentage of foreign bodies are radiolucent in adults with diagnosis challenging.
Methods: retrospective review of adult patients with FBA diagnosed by flexible electronic bronchoscopy from 2012 to 2022 collecting demographics, history, hospital presentation, radiographic, and operative details. Risk factors associated with radiolucent foreign body inhalation in adults were explored using appropriate statistical methods.
Results: between 1 January 2012 and 1 January 2022, 114 adult patients diagnosed with FBA were enrolled. The median age of participants was 65 years (IQR 52–74). Multidetector computed tomography (MDCT) examinations identified 28 cases (25%) showing direct visualization of the foreign body (defined as the radiopaque group) and 86 cases (75%) in the radiolucent group. Multivariable stepwise linear regression analysis showed increased odds of radiolucent foreign body inhalation in adults associated with pneumonic patches in MDCT (OR 6.99; 95% CI 1.80–27.22; P = 0.005) and plants/meat foreign bodies (OR 6.17; 95% CI 1.12–33.96; P = 0.04). A witnessed choking history (OR 0.02; 95% CI 0–0.14; P < 0.001) was a protective factor of radiolucent foreign body inhalation in adults.
Conclusions: unlike radiopaque FBA, in those presenting with a suspected radiolucent foreign body aspiration, the diagnosis is far more challenging. Risk factors such as lacking a choking history, non-resolving pneumonia (pneumonic patches) in MDCT findings, and plants/meat foreign bodies may help in the early diagnosis of radiolucent foreign body inhalation in adults. Further prospective multicenter studies should be conducted to validate the findings.
Text
FBA_Respiratory Research
- Accepted Manuscript
Restricted to Repository staff only
Request a copy
Text
s12931-022-02165-9
- Version of Record
More information
Accepted/In Press date: 2 September 2022
Published date: 10 September 2022
Additional Information:
Funding Information: YW was funded by the UK Medical Research Council (MR/S025480/1) and the UK Royal Society (IEC\NSFC\191030). CS was funded by the National Natural Science Foundation of China (81800064), Science project of the Wuhan Bureau of Science and Technology (2020020601012322), and Science project of the Wuhan Health Commission (WX20Q11). The funding bodies and sponsors had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.
Keywords:
Adult, Flexible bronchoscopy, Foreign body aspiration, Multi-detector Computed Tomography (MDCT), Radiolucent, radiopaque
Identifiers
Local EPrints ID: 470396
URI: http://eprints.soton.ac.uk/id/eprint/470396
ISSN: 1465-9921
PURE UUID: aee6e1c3-bf66-4a1c-8975-6448b2e096ca
Catalogue record
Date deposited: 07 Oct 2022 16:56
Last modified: 17 Mar 2024 03:39
Export record
Altmetrics
Contributors
Author:
Xiaofan Liu
Author:
Fang Ni
Author:
Tao Guo
Author:
Fangfang Jiang
Author:
Yan Jiang
Author:
Cheng Song
Author:
Mingli Yuan
Author:
Zhaowu Tao
Author:
Mingxin Ye
Author:
Junjie Xu
Author:
Ying Wang
Author:
Qiong Qian
Author:
Yi Hu
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
