Retained foreign bodies during surgery in pediatric patients: a national perspective.
BACKGROUND
Attention has been placed on surgical and medical errors, though there is a lack of data on the frequency of some complications.


METHODS
International Classification of Diseases, Ninth Revision, Clinical Modification, code 998.4 and E code 871.0 were used to search a database from the United States.


RESULTS
In the Kids' Inpatient Database 2003, there were 103 reports of retained foreign bodies after surgery (incidence, 0.0031%) with a mean age of 11.5 years. There was a wide range between the 36 states sampled. Total charges for a patient with this complication are $56,683 (95% confidence interval, $41,327-$72,039); mean length of stay is 10.5 days. There is an increased charge of $42,077 in patients who have this complication (P < .0001). Of the cases, 74% occurred at teaching institutions.


CONCLUSIONS
On a national perspective in the United States, the rate of a retained foreign body is 0.0031% or approximately 1 in 32,672 cases and is associated with an increased charge of $42,077 for this complication. Comparative data demonstrate that pediatric surgery in the United States is exceptionally safe with regard to retained foreign bodies.
Shah
Rahul K
RK
Division of Otolaryngology, Children's National Medical Center, Washington, DC 20010, USA. rshah@cnmc.org
Lander
Lina
L
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D005260:Female; D005547:Foreign Bodies / Q000191:economics / Q000453:epidemiology* / Q000209:etiology*; D019538:Health Care Surveys; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology / Q000209:etiology*; D011336:Probability; D011787:Quality of Health Care; D012086:Reoperation; D018570:Risk Assessment; D017751:Safety Management; D017678:Sex Distribution; D013525:Surgical Instruments / Q000009:adverse effects; D013514:Surgical Procedures, Operative / Q000009:adverse effects* / Q000379:methods; D015503:Surgical Sponges / Q000009:adverse effects; D015996:Survival Rate; D014481:United States / Q000453:epidemiology