Diabetes is an independent risk factor for delayed perforation after foreign bodies impacted in esophagus in adults.

Background: Perforation is the most serious complication of esophageal foreign bodies. Studies examining the association between diabetes and esophageal foreign body-induced perforation are largely non-existent.

Objectives: The purpose of this study was to identify the risk factors for esophageal foreign body-induced perforation.

Methods: A retrospective chart review of patients with esophageal foreign bodies between January 2012-January 2017 was performed at the Chinese People's Liberation Army General Hospital. The patients were divided into two groups: those complicated with perforation and those without perforation. Date on patient demographics, symptoms, foreign bodies, and diabetes were collected and analyzed. Study-specific odds ratio and 95% confidence intervals (CI) were estimated using multivariable logistic regression models.

Results: Of 294 patients with esophageal foreign bodies (41.84% male, mean age, 56.73 years), 33 (11.22%) complicated by perforation. Diabetes (odds ratio = 6.00; 95% confidence interval = 1.72-20.23), duration (>24 h) of foreign bodies retention (odds ratio = 4.25; 95% confidence interval = 1.71-10.86), and preoperative fever (odds ratio = 8.19; 95% confidence interval = 3.17-21.74) were strongly associated with an increased risk of perforation, whereas the sensation of a foreign body (odds ratio = 0.32; 95% confidence interval = 0.09-0.92) was a protective factor of perforation. Glucose level was not observed to have an association among patients with or without perforation.

Conclusions: Diabetes and duration of foreign body retention increase risk for esophageal foreign bodies complicated by perforation, and cases with elevated armpit temperature may represented a more likely perforation compared with those without fever.