@article{ref1,
title="Pediatric button battery ingestion: a single center experience and risk score to predict severe outcomes",
journal="Journal of pediatric surgery",
year="2022",
author="Scalise, P. Nina and Durgin, Jonathan M. and Staffa, Steven J. and Wynne, Nicole and Meisner, Jay and Ngo, Peter and Zendejas, Benjamin and Kim, Heung Bae and Demehri, Farokh R.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: The purpose of this study was to analyze the management and outcomes of primary button battery ingestions and their sequelae at a single high-volume center, and to propose a risk score to predict the likelihood of a severe outcome. <br><br>METHODS: The medical record was queried for all patients under 21 years old evaluated at our institution for button battery ingestion from 2008 to 2021. A severe outcome was defined as having at least one of the following: deep/circumferential mucosal erosion, perforation, mediastinitis, vascular or airway injury/fistula, or development of esophageal stricture. From a selection of clinically relevant factors, logistic regression determined predictors of a severe outcome, which were incorporated into a risk model. <br><br>RESULTS: 143 patients evaluated for button battery ingestion were analyzed. 24 (17%) had a severe outcome. The independent predictors of a severe outcome in multivariate analysis were location of battery in the esophagus on imaging (96%), battery size >/ = 2 cm (95%), and presence of any symptoms on presentation (96%), with P < 0.001 in all cases. Predicted probability of a severe outcome ranged from 88% when all three risk factors were observed, to 0.3% when none were present. <br><br>CONCLUSION: We report the presentation, management, and complication profiles of a large cohort of BB ingestions treated at a single institution. A risk score to predict severe outcomes may be used by providers initially evaluating patients with button battery ingestion in order to allocate resources and expedite transfer to a center with pediatric endoscopic and surgical capabilities. LEVEL OF EVIDENCE: Level IV. TYPE OF STUDY: Clinical Research Paper.<p /> <p>Language: en</p>",
language="en",
issn="0022-3468",
doi="10.1016/j.jpedsurg.2022.12.017",
url="http://dx.doi.org/10.1016/j.jpedsurg.2022.12.017"
}