To assess the prevalence of food/foreign body asphyxia in the elderly Viennese population
in order to reduce the incidence of these fatal events.
This is an autopsy-based, retrospective study in Vienna, Austria. Participants included
all nonhospitalized (n =200) cases of choking in 1984 to 2001, from a total 42,745 consecutive autopsies
performed at the Institute of Forensic Medicine. In addition, data from hospitalized
adult cases of fatal choking (n =73) in 1984 to 2001, from the mortality registrar of Vienna, were included.
The nonhospitalized choking victims were analyzed according to age (18 to 64 vs ≥65
years), sex, circumstances of death, and predisposing factors. Hospitalized cases
were analyzed according to age, sex, and whether an autopsy was already performed
by pathologists at the institution where they died. In the study period, 273 adults
died of food/foreign body asphyxia, 73% of them out of the hospital and 27% in hospitals.
Food/foreign body asphyxia in the elderly was characterized by a significantly higher
asphyxiation of soft/slick foods (p <0.007) with agomphiasis (p <0.002), occurring most frequently during lunch (49%), and in 2.5% during feeding
of neurologically impaired. In contrast, younger individuals choked significantly
more often on large pieces of foreign material (p <0.002) and showed a significantly higher rate of blood alcohol concentration (p <0.001).
This study demonstrates that semisolid foods are the cause of a large number of asphyxiations,
especially among the elderly. Knowledge of the fact that semisolid foods are a high-risk
factor in elderly individuals should be distributed in public and private healthcare
systems, and awareness could be a first step in reducing the incidence of food/foreign