Interhospital transfer dynamics in foreign body aspiration: Age-stratified nationwide retrospective cohort study.

Background: Foreign body aspiration (FBA) is an acute clinical emergency that is particularly common in the pediatric population and, if not managed promptly, can lead to serious morbidity and mortality across all age groups. The need for bronchoscopy, intensive care capabilities, and experienced teams often makes interhospital transfer unavoidable. This study aimed to evaluate the transfer dynamics of patients transferred due to FBA and to identify potential differences among age groups. Methods: In this retrospective cohort nationwide study, patients who underwent interhospital transfer due to FBA across Türkiye between 2022 and 2024 were included. Patients were stratified into three age groups: Pediatric (0-17 years), adult (≥18 years), and geriatric (≥65 years). The primary variables analyzed included transfer distance, transfer timing (working hours Results: A total of 2.816 patients were analyzed, including 1.135 (40.3%) females and 1.681 (59.7%) males. The median age was three years (12, 0-97). Pediatric patients were more frequently transferred to out-of-province centers compared to adults (odds ratio [OR] 1.90; 95% confidence interval [Cl]: 1.44-2.52; p<0.001) and had significantly longer transfer distances (p<0.001). In comparisons with other age groups, geriatric patients had higher rates of intra-provincial transfers (OR =1.65; 95% Cl: 1.08-2.51; p=0.013) and shorter transfer distances (p=0.010). However, when directly compared with pediatric patients, geriatric patients were more frequently transferred out of province (OR 1.74; 95% CI 1.18-2.57; p=0.006) and over longer di stances (p=0.004). Conclusion: Age groups have a significant impact on the type and distance of interhospital transfers in FBA cases. In contrast, the timing of transfer and mode of transportation do not differ significantly by age.