title: The clinical features of foreign body aspiration into the lower airway in geriatric patients.
abstract: OBJECTIVE
  To analyze the clinical features of foreign-body aspiration into the lower airway in geriatric patients.
  
  
  METHODS
  The clinical data of 17 geriatric patients with foreign-body aspiration were retrospectively analyzed and compared with 26 nongeriatric adult patients. The data were collected from Peking University First Hospital and Anhui Chest Hospital between January 2000 and June 2014.
  
  
  RESULTS
  (1) In the geriatric group, the most common symptoms were cough and sputum (15 cases, 88%), dyspnea (six cases, 35%), and hemoptysis (four cases, 24%). Five patients (29%) in the geriatric group could supply the history of aspiration on their first visit to doctor, a smaller percentage than in the nongeriatric group (13 cases, 50%). Only three cases in the geriatric group were diagnosed definitely without delay. Another 14 cases were misdiagnosed as pneumonia or lung cancer, and the time of delayed diagnosis ranged from 1 month to 3 years. Complications due to delay in diagnosis included obstructive pneumonitis, atelectasis, lung abscess, and pleural effusion. (2) Chest computed tomography demonstrated the foreign body in three cases (21%) in the geriatric group, which was lower than the positive proportion of detection in the nongeriatric group (nine cases, 35%). The most common type of foreign body in the geriatric group was food, such as bone fragments (seven cases, 41%) and plants (seven cases, 41%), and the foreign body was most often lodged in the right bronchus tree (eleven cases, 65%), especially the right lower bronchus (seven cases, 41%). Flexible bronchoscopy removed the foreign body successfully in all patients.
  
  
  CONCLUSIONS
  The clinical features of foreign-body aspiration in geriatric patients are usually more obscure than in nongeriatric adults, which may lead to long delay in diagnosis. Flexible bronchoscopy is safe and useful for early diagnosis and effective management in geriatric patients. We suggest flexible bronchoscopy as the first-line approach to similar patients, especially those with aspiration history and unexplained pneumonia.
authors.affiliation: Geriatric Department, Peking University First Hospital, Beijing, People's Republic of China.
authors.forename: Lianjun
authors.initials: L
authors.lastname: Lin
authors.affiliation: Pulmonary Intervention Department, Anhui Chest Hospital, Hefei, People's Republic of China.
authors.forename: Liping
authors.initials: L
authors.lastname: Lv
authors.affiliation: Geriatric Department, Peking University First Hospital, Beijing, People's Republic of China.
authors.forename: Yuchuan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Pulmonary Intervention Department, Anhui Chest Hospital, Hefei, People's Republic of China.
authors.forename: Xiankui
authors.initials: X
authors.lastname: Zha
authors.affiliation: Pulmonary Intervention Department, Anhui Chest Hospital, Hefei, People's Republic of China.
authors.forename: Fei
authors.initials: F
authors.lastname: Tang
authors.affiliation: Geriatric Department, Peking University First Hospital, Beijing, People's Republic of China.
authors.forename: Xinmin
authors.initials: X
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi; D001999:Bronchoscopy; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000175:diagnosis / Q000209:etiology; D053120:Respiratory Aspiration / Q000175:diagnosis* / Q000628:therapy*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: airway foreign-body aspiration; flexible bronchoscopy; geriatric patients