Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Pediatr. Dec 9, 2026; 15(4): 120948
Published online Dec 9, 2026. doi: 10.5409/wjcp.120948
Published online Dec 9, 2026. doi: 10.5409/wjcp.120948
Derivation of a clinical-radiological scoring system to predict foreign body aspiration in children
Lianne Dmello, Tarun John K Jacob, Arun Kumar Loganathan, Department of Paediatric Surgery, Christian Medical College and Hospital, Vellore 632004, Tamil Nādu, India
Author contributions: Dmello L and Jacob TJK contributed to data analysis; Dmello L was involved in data collection, and drafted the manuscript; Jacob TJK and Loganathan AK contributed to the study conception and design; Jacob TJK contributed to critically revised the manuscript for important intellectual content; Loganathan AK contributed to participated in manuscript writing, and critically revised and edited the manuscript for important intellectual content.
AI contribution statement: ChatGPT and Grammarly were used in a limited capacity during manuscript preparation and in preparing the response to the reviewers’ comments. No section of the manuscript, including the abstract, introduction, materials and methods, results, discussion, or conclusion, was wholly generated by artificial intelligence. The scientific content, study design, data collection, statistical analysis, interpretation of results, and final conclusions were entirely developed, verified, and approved by the authors. ChatGPT was used only to assist with language refinement, improving readability, grammatical structure, and clarity of presentation, including assistance in achieving abstract word-count requirements and improving the phrasing of selected portions of the introduction and discussion sections. Grammarly was used for grammar and language correction. For the response to the reviewers’ comments, ChatGPT was used to help improve the wording, structure, tone, and clarity of the authors’ responses so that the intended explanations could be conveyed appropriately and professionally. The substance of each response, including the interpretation of the reviewers’ comments, the description of changes made to the manuscript, and the decisions regarding manuscript revision, was entirely determined, checked, and approved by the authors. AI tools were not used for data analysis, statistical interpretation, generation of scientific conclusions, study conception, study design, methodology development, interpretation of results, or clinical decision-making related to this study. No images, figures, tables, or graphical content included in the manuscript were generated using artificial intelligence tools. The authors take full responsibility for the accuracy, integrity, and final content of both the manuscript and the response to reviewers.
Institutional review board statement: Institutional review board for ethics approval obtained - IRB Min. No. 14244 dated 08.09.2021 - Christian Medical College and Hospital, Vellore.
Informed consent statement: This was a retrospective cohort study conducted using anonymized data obtained from institutional medical records over a 10-year period. Patients were not contacted during the study, and no identifiable individual patient information has been included in the manuscript. The study protocol, including waiver of individual informed consent, was reviewed and approved by the Institutional Review Board/Ethics Committee, as the research involved analysis of previously collected anonymized data with minimal risk to participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The corresponding author can be contacted for any data-related queries.
Corresponding author: Arun Kumar Loganathan, Associate Professor, Department of Paediatric Surgery, Christian Medical College and Hospital, 6th Floor, ISSCC Building, Vellore 632004, Tamil Nādu, India. nishadocarun@gmail.com
Received: March 12, 2026
Revised: May 15, 2026
Accepted: June 2, 2026
Published online: December 9, 2026
Processing time: 191 Days and 16.3 Hours
Revised: May 15, 2026
Accepted: June 2, 2026
Published online: December 9, 2026
Processing time: 191 Days and 16.3 Hours
Core Tip
Core Tip: Diagnosing pediatric foreign body aspiration remains challenging and is associated with high negative rigid bronchoscopy rates. We derived a novel 17-point clinical-radiological scoring system that achieved an area under the curve of 0.791 and a sensitivity of 83.4%. This score heavily emphasizes the absence of respiratory mimics (concurrent upper respiratory tract infections or asthma) alongside classic predictors. Accordingly, we propose a practical emergency algorithm in which children scoring ≥ 10 undergo immediate rigid bronchoscopy, while those scoring ≤ 6 may be initially evaluated with flexible bronchoscopy. This approach optimizes patient selection and reduces unnecessary invasive procedures and associated complications.