Epidemiologic Features and Outcomes of Caustic Ingestions; a 10-Year Cross-Sectional Study
Archives of Academic Emergency Medicine,
Vol. 5 No. 1 (2017),
1 January 2017
,
Page e56
https://doi.org/10.22037/aaem.v5i1.181
Abstract
Introduction:Â Caustic ingestions are among the most prevalent causes of toxic exposure. The present 10-year survey aimed to evaluate the epidemiologic features and outcomes of caustic ingestion cases presenting to emergency department.
Methods: This is a retrospective cross-sectional study on patients who were admitted to a referral toxicology center during 2004 to 2014, following caustic ingestion. Baseline characteristics, presenting chief complaint, severity of mucosal injury, complications, imaging and laboratory findings as well as outcomes (need for ICU admission, need for surgery, mortality) were recorded, reviewing patients’ medical profile, and analyzed using SPSS 22.
Results: 348 patients with mean age of 37.76 ± 17.62 years were studied (55.6% male). The mean amount of ingested caustic agent was 106.69 ± 100.24 mL (59.2 % intentional). Intentional ingestions (p < 0.0001), acidic substance (p = 0.054), and higher volume of ingestion (p = 0.021) were significantly associated with higher severity of mucosal damage. 28 (8%) cases had died, 53 (15.2%) were admitted to ICU, and 115 (33%) cases underwent surgery.
Conclusion:Â It seems that, suicidal intention, higher grade of mucosal injury, higher volume of ingestion, lower level of consciousness, lower serum pH, and higher respiratory rate are among the most important predictors of need for ICU admission, need for surgery, and mortality.
- Caustics
- epidemiology
- toxicology
- suicide
- attempted
- patient outcome assessment
How to Cite
References
Arévaloâ€Silva C, Eliashar R, Wohlgelernter J, Elidan J, Gross M. Ingestion of caustic substances: a 15â€year experience. The Laryngoscope. 2006;116(8):1422-6.
Bronstein AC, Spyker DA, Cantilena Jr LR, Green JL, Rumack BH, Heard SE. 2007 annual report of the American Association of Poison Control Centers' National poison data system (NPDS): 25th Annual report. Clinical Toxicology. 2008;46(10):927-1057.
Elshabrawi M, A-Kader HH. Caustic ingestion in children. Expert review of gastroenterology & hepatology. 2011;5(5):637-45.
Mowry JB, Spyker DA, Brooks DE, McMillan N, Schauben JL. 2014 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 32nd Annual Report. Clinical toxicology. 2015;53(10):962-1147.
Rollin M, Jaulim A, Vaz F, Sandhu G, Wood S, Birchall M, et al. Caustic ingestion injury of the upper aerodigestive tract in adults. Annals of the Royal College of Surgeons of England. 2015;97(4):304.
Kikendall J. Caustic ingestion injuries. Gastroenterology Clinics of North America. 1991;20(4):847-57.
Riffat F, Cheng A. Pediatric caustic ingestion: 50 consecutive cases and a review of the literature. Diseases of the Esophagus. 2009;22(1):89-94.
Haller Jr A, Gibbs Andrews H, White JJ, Akram Tamer M, Cleveland WW. Pathophysiology and management of acute corrosive burns of the esophagus: results of treatment in 285 children. Journal of pediatric surgery. 1971;6(5):578-84.
Thompson JN. Corrosive esophageal injuries I. A study of nine cases of concurrent accidental caustic ingestion. The Laryngoscope. 1987;97(9):1060-8.
Thompson JN. Corrosive esophageal injuries. II. An investigation of treatment methods and histochemical analysis of esophageal strictures in a new animal model. The Laryngoscope. 1987;97(10):1191-202.
Zargar SA, Kochhar R, Mehta S, Mehta SK. The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns. Gastrointestinal endoscopy. 1991;37(2):165-9.
Brunicardi F, Andersen D, Billiar T, Dunn D, Hunter J, Matthews J, et al. Schwartz's Principles of Surgery, 10th edition: McGraw-Hill Education; 2014.
Campbell GS, Burnett HF, Ransom JM, Williams GD. Treatment of corrosive burns of the esophagus. Archives of Surgery. 1977;112(4):495.
Haller JA, Bachman K. The comparative effect of current therapy on experimental caustic burns of the esophagus. Pediatrics. 1964;34(2):236-45.
Hill JL, Norberg HP, Smith MD, Young JA, Reyes HM. Clinical technique and success of the esophageal stent to prevent corrosive strictures. Journal of pediatric surgery. 1976;11(3):443-50.
Paudyal B. Poisoning: pattern and profile of admitted cases in a hospital in central Nepal. JNMA J Nepal Med Assoc. 2005;44(159):92-6.
Tüfekçi IB, Curgunlu A, Şirin F. Characteristics of acute adult poisoning cases admitted to a university hospital in Istanbul. Human & experimental toxicology. 2004;23(7):347-51.
Cheng H-T, Cheng C-L, Lin C-H, Tang J-H, Chu Y-Y, Liu N-J, et al. Caustic ingestion in adults: The role of endoscopic classification in predicting outcome. BMC Gastroenterology. 2008;8(1):31.
Cabral C, Chirica M, de Chaisemartin C, Gornet J-M, Munoz-Bongrand N, Halimi B, et al. Caustic injuries of the upper digestive tract: a population observational study. Surgical endoscopy. 2012;26(1):214-21.
Yeganeh R, Peyvandi H, Mohajeri M, Bashtar R, Bashashati M, Ahmadi M. Investigation of mortality after corrosive ingestion: A prospective study. Acta Medica Iranica. 2009;47(1):15-9.
Chang J-M, Liu N-J, Pai BC-J, Liu Y-H, Tsai M-H, Lee C-S, et al. The Role of Age in Predicting the Outcome of Caustic Ingestion in Adults: A Retrospective Analysis. BMC Gastroenterology. 2011;11(1):72.
Ertekin C, Alimoglu O, Akyildiz H, Guloglu R, Taviloglu K. The results of caustic ingestions. Hepato-gastroenterology. 2003;51(59):1397-400.
Poley J-W, Steyerberg EW, Kuipers EJ, Dees J, Hartmans R, Tilanus HW, et al. Ingestion of acid and alkaline agents: outcome and prognostic value of early upper endoscopy. Gastrointestinal Endoscopy. 2004;60(3):372-7.
Ducoudray R, Mariani A, Corte H, Kraemer A, Munoz-Bongrand N, Sarfati E, et al. The Damage Pattern to the Gastrointestinal Tract Depends on the Nature of the Ingested Caustic Agent. World journal of surgery. 2016;40(7):1638-44.
Cheng Y-J, Kao E-L. Arterial Blood Gas Analysis in Acute Caustic Ingestion Injuries. Surgery Today. 2003;33(7):483-5.
- Abstract Viewed: 286 times
- PDF Downloaded: 143 times
- HTML Downloaded: 95 times
