title: Cost varies with procedure type in pediatric GI foreign bodies.
abstract: OBJECTIVE
  In pediatric cases of ingested foreign bodies, gastrointestinal foreign bodies (GIFB) have distinct factors contributing to longer and more costly hospitalizations.
  
  
  METHODS
  Patients admitted with ingested foreign bodies were identified in the Kids' Inpatient Database (1997-2009).
  
  
  RESULTS
  Overall, 7480 cases were identified. Patients were most commonly <5years of age (44%), male (54%), and Caucasian (57%). A total of 2506 procedures were performed, GI surgical procedures (57%) most frequently, followed by GI endoscopy (24%), esophagoscopy (11%), and bronchoscopy - in cases of inhaled objects (9%). On multivariate analysis, length of stay increased when cases were associated with intestinal obstruction (OR=1.7), esophageal perforation (OR=40.0), intestinal perforation (OR=4.4), exploratory laparotomy (OR=1.9), and gastric (OR=2.9), small bowel (OR=1.5), or colon surgery (OR=2.5), all p<0.02. Higher total charges (TC) were associated with intestinal obstruction (OR=2.0), endoscopy of esophagus (OR=1.8), stomach (OR=2.1), or colon (OR=3.3), and exploratory laparotomy (OR=3.6) or surgery of stomach (OR=5.6), small bowel (OR=6.4), or colon (OR=3.4), all p<0.001.
  
  
  CONCLUSIONS
  Surgical or endoscopic procedures are performed in approximately one third of GIFB cases. Associated psychiatric disorder or self-inflicted injury is seen in more than 20% of GIFB patients. Resource utilization is determined heavily by associated diagnoses and treatment procedures.
authors.affiliation: Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Kennedy
authors.affiliation: Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Starker
authors.affiliation: Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Feldman
authors.affiliation: Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Tashiro
authors.affiliation: Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Perez
authors.affiliation: Children's Emergency Center, Baptist Children's Hospital, Miami, FL, USA.
authors.forename: Fernando G
authors.initials: FG
authors.lastname: Mendoza
authors.affiliation: Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA. Electronic address: JSola@med.miami.edu.
authors.forename: Juan E
authors.initials: JE
authors.lastname: Sola
mesh_terms: D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D013505:Digestive System Surgical Procedures / Q000191:economics* / Q000379:methods; D004939:Esophageal Perforation / Q000191:economics / Q000209:etiology; D004945:Esophagoscopy / Q000191:economics; D004947:Esophagus; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000191:economics* / Q000601:surgery; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007415:Intestinal Obstruction / Q000191:economics / Q000209:etiology; D007416:Intestinal Perforation / Q000191:economics / Q000209:etiology; D007902:Length of Stay; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013270:Stomach
keywords: Foreign bodies; Health resources; Pediatrics