Respiratory sign patterns, clinical characteristics, and hospital course in children with foreign body aspiration: a retrospective cohort study.
- 1Department of Pulmonology, Shanghai Children's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Abstract
Children with foreign body aspiration (FBA) exhibit considerable clinical heterogeneity. This exploratory study examined whether combinations of wheezing and diminished breath sounds were associated with clinical characteristics and hospital course among children with bronchoscopically confirmed FBA. This retrospective cohort study included 174 children with bronchoscopically confirmed bronchial FBA admitted to Shanghai Children's Hospital between January 2020 and December 2024. Four respiratory sign patterns were defined by the presence or absence of wheezing (W) and diminished breath sounds (D): W0D0, W0D1, W1D0, and W1D1. Associations of respiratory sign patterns with binary clinical characteristics were assessed using Firth penalized logistic regression, whereas associations with length of hospital stay (LOS) were assessed using Huber M-estimation robust regression, with median regression used as a sensitivity analysis for LOS. Modified Poisson regression, Benjamini-Hochberg false-discovery-rate (BH-FDR) adjustment, global 3-degree-of-freedom interaction tests, and an expanded-cohort analysis re-including 20 tracheal cases were also performed. Compared with W0D0, W1D1 was associated with lower odds of radiologically identified pneumonia [odds ratio (OR) =0.40, 95% confidence interval (CI): 0.17-0.96; P=0.04] and a shorter LOS (β=-0.96, 95% CI: -1.73 to -0.19; P=0.01). Neither association remained below the BH-FDR threshold (both q=0.312). No significant effect modification by sex, age group, or foreign body laterality was detected for pneumonia or LOS (all global interaction P>0.05). Modified Poisson regression yielded an adjusted PR of 0.63 (95% CI: 0.42-0.95; P=0.03) for pneumonia, whereas median regression showed a similar -1.00-day difference in LOS (95% CI: -2.12 to 0.12; P=0.08). Expanded-cohort analyses showed directionally similar results. Respiratory sign patterns showed exploratory associations with pneumonia and hospital course in children with bronchial FBA. These findings may help identify clinical heterogeneity but require prospective validation before predictive or clinical use.
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BibTeX
@article{zhu2026respiratory,
title = {{Respiratory sign patterns, clinical characteristics, and hospital course in children with foreign body aspiration: a retrospective cohort study.}},
author = {Ruochen Zhu and Kun Jiang},
journal = {Translational pediatrics},
year = {2026},
month = sep,
doi = {10.21037/tp-2026-0741},
url = {https://europepmc.org/article/MED/42996730},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Respiratory sign patterns, clinical characteristics, and hospital course in children with foreign body aspiration: a retrospective cohort study.
AU - Ruochen Zhu
AU - Kun Jiang
PY - 2026
DA - 2026/09/30
JO - Translational pediatrics
DO - 10.21037/tp-2026-0741
UR - https://europepmc.org/article/MED/42996730
AB - Children with foreign body aspiration (FBA) exhibit considerable clinical heterogeneity. This exploratory study examined whether combinations of wheezing and diminished breath sounds were associated with clinical characteristics and hospital course among children with bronchoscopically confirmed FBA. This retrospective cohort study included 174 children with bronchoscopically confirmed bronchial FBA admitted to Shanghai Children's Hospital between January 2020 and December 2024. Four respiratory sign patterns were defined by the presence or absence of wheezing (W) and diminished breath sounds (D): W0D0, W0D1, W1D0, and W1D1. Associations of respiratory sign patterns with binary clinical characteristics were assessed using Firth penalized logistic regression, whereas associations with length of hospital stay (LOS) were assessed using Huber M-estimation robust regression, with median regression used as a sensitivity analysis for LOS. Modified Poisson regression, Benjamini-Hochberg false-discovery-rate (BH-FDR) adjustment, global 3-degree-of-freedom interaction tests, and an expanded-cohort analysis re-including 20 tracheal cases were also performed. Compared with W0D0, W1D1 was associated with lower odds of radiologically identified pneumonia [odds ratio (OR) =0.40, 95% confidence interval (CI): 0.17-0.96; P=0.04] and a shorter LOS (β=-0.96, 95% CI: -1.73 to -0.19; P=0.01). Neither association remained below the BH-FDR threshold (both q=0.312). No significant effect modification by sex, age group, or foreign body laterality was detected for pneumonia or LOS (all global interaction P>0.05). Modified Poisson regression yielded an adjusted PR of 0.63 (95% CI: 0.42-0.95; P=0.03) for pneumonia, whereas median regression showed a similar -1.00-day difference in LOS (95% CI: -2.12 to 0.12; P=0.08). Expanded-cohort analyses showed directionally similar results. Respiratory sign patterns showed exploratory associations with pneumonia and hospital course in children with bronchial FBA. These findings may help identify clinical heterogeneity but require prospective validation before predictive or clinical use.
SN - 2224-4336
SN - 2224-4344
ER -