Diagnostic Value of a New Foreign Body Aspiration Score (FBAS) in Evaluation of Children at the Emergency Department

Background: Foreign body aspiration (FBA) is a significant cause of morbidity among young children. Flexible bronchoscopy (FB), an invasive procedure, is the procedure of choice in cases with equivocal diagnosis. . The decision to preform FB in suspected cases depends on the physician`s experience rather than on a uniform algorithm.

Aim: to assess the ability of a new clinical foreign body aspiration score (FBAS) in predicting FBA in children.

Methods: a prospective study, enrolling patients aged 0-18 years, referred to the emergency department (ED) at Soroka University Medical Center, for suspected FBA, between November 2019 and November 2020. FBAS was calculated according to the score`s parameters; chocking episode (2 points), sudden cough (1 point), exposure to nuts (1 point), absence of fever/ rhinitis (1 point), stridor (1 point), unilateral auscultation findings (2 points) and unilateral radiological finding (2 points)., .Total score indicates low (1-3), moderate (4-7) or high (8-10) risk for FBA. Demographics, clinical assessment and outcomes were statistically analyzed.

Results: 73 patients were enrolled (52.7% males, median age of 21 months). Within 34 children with low score, 30 children with moderate score and 9 children with high score, only one (2.7%), 14 (46.7%) and 8 (88.9%) were diagnosed with FBA, respectively (p<0.001). Logistic regression indicated that children with higher score had higher risk of FBA; OR 2.5 95%CI 1.612-4.012 for each additional point. Area Under the ROC Curve for predicting FBA was 0.878.

Conclusion: FBAS algorithm reliably predicts the presences of inhaled foreign body in children at the ED