Evidence map›Paper›PMID 40960685›Full record

ArticleCJEM2025

Timeliness of management of button battery impactions in children in the province of Ontario: a multi-center analysis.

Nikolaus E Wolter, Jennifer M Siu, Jacob Davidson, Ayushi Bhatt, Olivia Ostrow, Ryan Rourke, Xinyuan Hong, Jonathan Maclean, Jakob Pugi, Kristina H Pulkki and 3 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in CJEM, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Nikolaus E WolterDepartment of Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada. nikolaus.wolter@sickkids.ca.ORCID 0000-0002-5196-6150
Jennifer M SiuDepartment of Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Jacob DavidsonDepartment of Surgery, Western University, London, ON, Canada.
Ayushi BhattDepartment of Otolaryngology, Western University, London, ON, Canada.
Olivia OstrowDivision of Pediatric Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children University of Toronto, Toronto, ON, Canada.
Ryan RourkeDepartment of Otolaryngology -Head and Neck Surgery, University of Ottawa, Ottawa, ON, Canada.
Xinyuan HongDepartment of Otolaryngology -Head and Neck Surgery, University of Ottawa, Ottawa, ON, Canada.
Jonathan MacleanDepartment of Surgery, Otolaryngology, Head & Neck Surgery Division, McMaster University, Hamilton, ON, Canada.
Jakob PugiDepartment of Surgery, Otolaryngology, Head & Neck Surgery Division, McMaster University, Hamilton, ON, Canada.
Kristina H PulkkiDivision of Otolaryngology - Head and Neck surgery, Department of Surgery, Thunder Bay Regional Health Sciences Center, Thunder Bay, ON, Canada.
Justine G PhilteosDepartment of Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
M Elise Graham *Division of Otolaryngology - Head and Neck surgery, Department of Surgery, IWK Health, Halifax, NS, Canada.
Natashia M Seemann *Department of Surgery, Western University, London, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEsophageal button battery impactions represent a life-threatening medical emergency in children. There are established clinical benchmarks to help reduce the risk of injury. Our objective was to describe the care pathways of children presenting with esophageal button battery impactions in the four main pediatric centers in Ontario.

methodsA multi-institutional health records review of button battery ingestion cases in children from 2012 to 2023 at four large-volume tertiary pediatric hospitals was conducted. Participants included children under 18 years who underwent esophagoscopy for battery removal.

resultsEighty-six children with button battery impactions were identified. The median age was 2.6 years. Fifteen children presented directly to a tertiary institution, while 71 (82.6%) were transferred from a community hospital. The median total distance traveled was 44.6 km. The median time from button battery diagnosis to removal was 7.9 h. Honey or sucralfate was administered in < 5% of cases. The median hospital stay was 3.1 days. Complications included esophageal perforation (2.3%), esophageal stricture (8.5%), tracheoesophageal fistula (1.2%), and vascular injury (1.2%), with one death reported. No cases met the benchmark of button battery removal within 2 h of ingestion, with significant delays occurring at every management stage.

conclusionDespite efforts to increase awareness and rapid management of button battery ingestion, significant delays, poor adherence to mitigation strategies, and serious complications persist. These findings emphasize the need for prevention and the development of regional and institution-specific protocols to provide timely and streamlined care.

Indexed as

Electric Power SuppliesEsophagoscopyEsophagusForeign BodiesAdolescentChildChild, PreschoolFemaleHumansInfantMaleOntarioRetrospective StudiesTime FactorsButton batteryEsophagusForeign bodyPediatric

Identifiers

PMID40960685

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.