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Abstract
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OBJECTIVES: To review the clinical management and outcomes of magnet ingestions at a large tertiary children's hospital. To determine the association of frequency of high-powered magnet ingestion with the regulation of these magnets.
PATIENTS AND METHODS: Children <18 years who presented to the emergency room and/or were admitted to the Children's Hospital of Philadelphia for ingestion of single or multiple magnets from 01/2008 to 12/2020 were included. Demographics, symptoms, management and outcomes were analyzed. The frequency of magnet ingestion was compared over 3 eras: 1) pre-ban (2008 - 2012) 2) intra-ban (2013 - 2016) and 3) post-ban (2017 - 2020).
RESULTS: There were 167 magnet ingestions, including 99 with multiple magnets. Most patients (59%) were male and median age was 6 (IQR 3-9) years. Most single magnet ingestions (86%) were discharged with outpatient monitoring, and none experienced severe outcomes. Multiple magnet ingestions led to significant morbidity including hospitalizations (68%), endoscopic procedures (48%), surgical procedures (14%) and severe outcomes (12%). Most patients (75%) were asymptomatic, however, there was a higher risk of surgery and severe complications based on the presence of symptoms (p = 0.003). The rate of surgical intervention was higher with ≥ 3 magnets (31.7%) compared to two magnets (2.4%) (P < 0.003). Additionally, we found an 160% increase in children with magnet ingestions in the post- ban period (p = 0.021).
CONCLUSION: Multiple magnet ingestion is associated with high morbidity and rate of severe outcomes. There is a relationship between public policy of magnet sale and frequency of magnet ingestion.
Keywords: Multiple magnet ingestion
Language: en |