Foreign Body Aspiration in Children: Impact of Delayed Presentation on Pediatric Intensive Care Unit Length of Stay, A Single-Center Study

Abstract

Objective: Foreign body aspiration (FBA) is a potentially life-threatening pediatric emergency in which delayed diagnosis and intervention may increase morbidity. This study aims to evaluate the demographic, clinical, radiological, and bronchoscopic characteristics of children undergoing bronchoscopy for suspected FBA and to investigate the impact of delayed presentation on intensive care unit length of stay.Material and Methods: This retrospective observational study includes pediatric patients aged 0-18 years who underwent rigid bronchoscopy for suspected FBA at a tertiary university hospital between 2014 and 2024. Demographic characteristics, presenting symptoms, physical examination findings, radiological findings, bronchoscopic results, and clinical outcomes were analyzed. Patients were divided into early presentation (within 24 hours) and delayed presentation (after 24 hours) groups. Diagnostic performance of chest radiography was evaluated using bronchoscopy as the gold standard.Results: A total of 82 patients were included in the study. Foreign bodies were detected in 57 patients (69.6%) during bronchoscopy, with the right main bronchus being the most common location. Peanut was the most frequently aspirated foreign body. The sensitivity and specificity of chest radiography were 78.9% (95% CI [66.7, 87.5]) and 87.0% (95% CI [67.9, 95.5]), respectively. Patients presenting after 24 hours had a significantly longer intensive care unit stay than those presenting earlier (median 0.5 vs 0 days; mean 1.25 vs 0.48 days; p = .022). Total length of hospital stay did not differ significantly between the groups (p = .227).Conclusion: Delayed hospital presentation following foreign body aspiration is associated with prolonged intensive care unit stay. Early diagnosis and timely bronchoscopy remain critical for preventing complications and improving clinical outcomes in pediatric patients with suspected foreign body aspiration.