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Intentional swallowing of foreign bodies and its impact on the cost of health care
Date:10/31/2010

PROVIDENCE, RI A new study from Rhode Island Hospital found that 33 individuals were responsible for 305 cases of medical intervention to remove foreign bodies that were intentionally swallowed, resulting in more than $2 million in estimated hospital costs. The findings appear in the November issue of Clinical Gastroenterology and Hepatology.

Through a retrospective case study over an 8-year period, the researchers identified 305 cases of the intentional ingestion of foreign bodies at Rhode Island Hospital, a Level I trauma center in Providence, RI. The most common items were pens (24 percent), batteries (9 percent), knives (7 percent) and razor blades (7 percent). For the most part, extraction of the foreign bodies was successful during the initial endoscopic extraction except for 20 cases, and only two cases eventually required a surgical extraction. The 305 cases were associated with 33 patients, of which 79 percent were previously diagnosed with a psychiatric disorder.

Steven Moss, MD, is a gastroenterologist at Rhode Island Hospital and lead author of the paper. Moss says, "Intentional foreign body ingestion occurs among a relatively small number of patients with psychiatric disorders and is costly. While endoscopic retrieval is relatively safe and effective, it often requires general anesthesia and utilizes significant hospitals resources."

In 237 of the cases, the foreign bodies were successfully retrieved, most commonly from the stomach or esophagus. Attempts at removal were not successful in only 10 cases and surgical consults were required for these patients. There were no cases of perforations or patient deaths. Hospital costs incurred in the patients' care from these 305 cases totaled $2,018,073, borne primarily by government payers (Medicare and Medicaid). The greatest contributors to the costs were nursing care (56 percent), followed by endoscopy, emergency department and surgical services.

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Contact: Nancy Cawley Jean
njean@lifespan.org
Lifespan
Source:Eurekalert

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