TY  - JOUR
PY  - 2022//
TI  - Pediatric button battery ingestion: a single center experience and risk score to predict severe outcomes
JO  - Journal of pediatric surgery
A1  - Scalise, P. Nina
A1  - Durgin, Jonathan M.
A1  - Staffa, Steven J.
A1  - Wynne, Nicole
A1  - Meisner, Jay
A1  - Ngo, Peter
A1  - Zendejas, Benjamin
A1  - Kim, Heung Bae
A1  - Demehri, Farokh R.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 0022-3468
UR  - http://dx.doi.org/10.1016/j.jpedsurg.2022.12.017
ID  - ref1
ER  -