title: The national cost burden of bronchial foreign body aspiration in children.
abstract: OBJECTIVE
  Foreign body aspiration (FBA) continues to be a concerning pediatric problem, accounting for thousands of emergency room visits and more than 100 deaths each year in the United States. The costs incurred with hospitalizations and procedures following these events are the focus of this study.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  The Nationwide Inpatient Sample from 2009 to 2011 was analyzed, and all cases with pediatric bronchial foreign body aspirations (International Classification of Diseases-9 codes: 934.0, 934.1, 934.8, and 934.9) were reviewed. Cases were analyzed to determine type of foreign body aspiration, procedural interventions performed, duration of inpatient stay, mortality rate, complications, and posthospitalization disposition. The median length of hospital stay and total costs associated with aspiration events were determined.
  
  
  RESULTS
  An estimated 1,908 ± 273 pediatric bronchial FBA patients were admitted annually over the 3-year period (mean age, 3.6 ± 0.3 years; 61.3% ± 1.9% male). The ratio of foreign object aspiration to food aspiration was 5:3. Overall, 56%.0 ± 3.6% of the patients underwent a bronchoscopic procedure for foreign body removal; of those, 41.5% ± 2.5% had a foreign body removed at the time of the endoscopy. The hospital mortality rate associated with bronchial aspiration was 1.8% ± 0.4%; and 2.2% ± 0.5% of patients were diagnosed with anoxic brain injury. The median length of stay was 3 days (25th-75th interquartile range, 1-7 days).The median charges and actual costs per case were $20,820 ($10,800-$53,453) and $6,720 ($3,628-$16,723), respectively.
  
  
  CONCLUSIONS
  The annual overall inpatient cost associated with pediatric bronchial foreign-body aspiration is approximately $12.8 million. Combined, the rate of death or anoxic brain injury associated with pediatric foreign body is approximately 4%.
  
  
  METHODS
  2C.
authors.affiliation: Otolaryngology-Head & Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Irene A
authors.initials: IA
authors.lastname: Kim
authors.forename: Nina
authors.initials: N
authors.lastname: Shapiro
authors.forename: Neil
authors.initials: N
authors.lastname: Bhattacharyya
mesh_terms: D001980:Bronchi; D002675:Child, Preschool; D005260:Female; D005547:Foreign Bodies / Q000191:economics* / Q000453:epidemiology; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: Foreign body; aspiration; bronchial; choking; cost; national