title: Risk factors for complications after a foreign body is retained in the esophagus.
abstract: BACKGROUND
  Foreign body (FB) ingestion is a common problem presenting to the emergency department (ED). The standard treatment, removal by endoscopy, is well established. However, some patients may refuse this invasive procedure due to their fear of an uncomfortable or painful experience. Obtaining hard evidence of potential complications of not having the FB removed by endoscopy would be helpful in convincing patients to have the procedure.
  
  
  OBJECTIVE
  The aim of this study was to identify the risk factors for developing complications after FB ingestion.
  
  
  METHODS
  The study was conducted over a period of 1 year (April 1, 2006 through March 31, 2007) at a referral medical center. Potential risk factors for developing complications (e.g., age, gender, type of FB, positive finding on radiography) were retrospectively evaluated in patients presenting with esophageal FBs and analyzed using chi-squared or Fisher's exact test and logistic regression.
  
  
  RESULTS
  A total of 225 patients were included. Fish bones were found to be the most common FBs (73.4%). The most commonly affected site was the oropharynx (64.5%). The complication rate was 9.7%. Risk factors for complications after FB ingestion were: 1) time interval over 24 h between FB ingestion and presenting to the ED; 2) a positive radiographic finding; 3) age > 50 years.
  
  
  CONCLUSIONS
  If a patient presents to the ED with at least one of the three risk factors identified, it is strongly suggested that the patient undergo endoscopy to remove the FB due to a higher risk for developing complications.
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital at Kaohsiung, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Hung
authors.forename: Shih-Chiang
authors.initials: SC
authors.lastname: Hung
authors.forename: Chao Jui
authors.initials: CJ
authors.lastname: Lee
authors.forename: Wen-Huei
authors.initials: WH
authors.lastname: Lee
authors.forename: Kuan Han
authors.initials: KH
authors.lastname: Wu
mesh_terms: D000367:Age Factors; D004487:Edema / Q000209:etiology; D004636:Emergency Service, Hospital; D004724:Endoscopy; D004939:Esophageal Perforation / Q000209:etiology; D004947:Esophagus / Q000000981:diagnostic imaging; D005547:Foreign Bodies / Q000150:complications* / Q000601:surgery; D006801:Humans; D022125:Lacerations / Q000209:etiology; D016015:Logistic Models; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D061665:Time-to-Treatment