Abstract

Background. Foreign body aspiration (FBA) is an important health problem associated with significant morbidity and mortality, especially among under three years of age.
Aims. The aim of the study was to describe the epidemiology of foreign bodies in lower respiratory tract among Estonian children and to assess the effectiveness and safety of bronchoscopy.
Methods. This was a retrospective study involving children (aged 0 – 18 years) from Tartu University Hospital and Tallinn Children’s Hospital databases, who were hospitalized between 01.01.2012 to 31.12.2021 with a diagnosis of lower respiratory tract FBA (International Classification of Diseases 10th Revision [ICD-10]) codes T17.4, T17.5, T17.8) confirmed on bronchoscopy.
Results. A total of 101 cases were included, 67% were boys. Most cases occurred in children aged one year to one year and 11 months old. Over the observation period the incidence remained stable ranging from 3,5 cases per 100 000 children in 2012, to 4,0 cases in 2021 (R2 = 0,04; p = 0,21). Adequate diagnosis and treatment were established within the first 24 h for 58% of the patients, while 20% received correct management more than one week after aspiration. Bronchoscopy most commonly revealed foreign bodies in the right main bronchus, with nuts being the most frequently found object. In 80% of children; the foreign body was successfully removed on the first attempt
and complications occurred in 8% of cases. Repeat bronchoscopy was necessary for 28 children, and pharmacological treatment was required in 85%. There were no deaths cases due to FBA in regional hospitals.
Conclusion. FBA is a persistent and potentially life-threatening problem in Estonia. The quality of treatment in regional hospitals is good, though the rate of repeat bronchoscopies is relatively high. To reduce the incidence of FBA and ensure timely management, it is important to educate healthcare workers and parents of toddlers.