O3216: Socioeconomic Disparities in Pediatric High-powered Magnet Ingestion Epidemiology and Outcomes

Background: High powered magnets are an increasingly frequent cause of unintentional injury in children. Despite the recent passage of regulations limiting the production of these magnets, ongoing advocacy and public education regarding the dangers of these products is needed. Such efforts are limited by the lack of data on how socioeconomic status (SES) impacts the incidence and prevention of these injuries. Thus, the goal of this study is to describe SES-associated differences in high powered magnet exposures.

Methods: In this multicenter, retrospective cohort study from 25 US children’s hospitals from 2017-2019, patients aged 0-21 years with a confirmed high-powered magnet ingestion or insertion were included. Details regarding demographics, exposure, injury, and treatment were collected. Children were grouped into SES groups based on zip code using the geocoded Childhood Opportunity Index (COI). Clinical characteristics and outcomes were compared between children with low (0-40) and high (41-100) COI scores.

Results: 594 patients with a high-powered magnet exposure were identified, of which 74.3% occurred among children with high COI scores. Children with a low COI score were less likely to have been directly supervised by a caregiver at the time of exposure (11.3% vs 17.4, p=0.047). Fewer parents in the low COI group (10.6 vs 19.4%, p=0.44) knew that magnets were dangerous. More children with a low COI had an injury compared to those with a high COI, although the difference was not statistically significant (13.2 vs 8.4%, p=0.08). Children with a low COI score were more likely to undergo both endoscopy and surgery (9.3 vs 2.9%, p=0.001), had a longer mean length of stay (4.4 days vs 3.3 days, p=0.007), and were more likely to require readmission (5.4 vs 1.6%, p=0.04) compared to those with a high COI score. Notably, there was no statistically significant difference in the time caregivers took to seek care; the time to the definitive care hospital; or the size or number of magnets per exposure.

Conclusion: Children with a higher SES account are more likely to have a high-powered magnet exposure, but children with a lower SES require more invasive procedures for treatment, longer stays in the hospital, and more readmissions . Caregivers across all SES groups need to be more aware of the danger these magnets pose, but these data illuminate opportunities for focused advocacy and education.