Investigation of Mortality after Corrosive Ingestion: A Prospective Study
Abstract
Ingested corrosive substances produce different injuries, ranging from minor gastro esophageal burns to death, depending on the agent type, amount, concentration, and duration of substance exposure. The purpose of this study was to investigate the outcomes and different causes of mortality in patients ingesting caustic substances. In a prospective study, between April 1999 and January 2006, a total of 1260 patients with a history of caustic agent ingestion were admitted to Loqman-Hakim hospital emergency ward. Patients who died despite our management were included in this study. Mortality rate was stratified as early (during the primary hospitalization) and delayed (after discharge from the hospital) based on the etiologies. Sixty-two patients died during follow up. Among patients who died, mean arrival time to the hospital was 12 hours from exposure, ranging from 30 minutes to 120 hours. Aspiration and airway obstruction were the leading causes of mortality accounting for 25 patients' death. Twenty-seven of them underwent surgical intervention, among whom 21 deaths occurred after early operations and 6 deaths after delayed reconstructive surgery. In cases of caustic ingestion, early admission and airway protection besides surgical intervention, if indicated, can reduce the mortality rate.
Satar S, Topal M, Kozaci N. Ingestion of caustic substances by adults. Am J Ther 2004; 11(4): 258-61.
Watson WA, Litovitz TL, Rodgers GC Jr, Klein-Schwartz W, Reid N, Youniss J, et al. 2004 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2005; 23(5): 589-666.
Cattan P, Munoz-Bongrand N, Berney T, Halimi B, Sarfati E, Celerier M. Extensive abdominal surgery after caustic ingestion. Ann Surg 2000; 231(4): 519-23.
Mamede RC, de Mello Filho FV. Ingestion of caustic substances and its complications. Sao Paulo Med J 2001; 119(1): 10-5.
Gumaste VV, Dave PB. Ingestion of corrosive substances by adults. Am J Gastroenterol 1992; 87(1): 1-5.
Schild JA. Caustic ingestion in adult patients. Laryngoscope 1985; 95(10): 1199-201.
Di Costanzo J, Noirclerc M, Jouglard J, Escoffier JM, Cano N, Martin J, et al. New therapeutic approach to corrosive burns of the upper gastrointestinal tract. Gut 1980; 21(5): 370-5.
Yegane RA, Bashashati M, Bashtar R, Ahmadi M. Gastrointestinal obstruction due to plaster ingestion: a case-report. BMC Surg 2006; 6: 4.
Zarghami M, Khalilian A. Deliberate self-burning in Mazandaran, Iran. Burns 2002; 28(2): 115-9.
Hojjati M, Saleh M, Osanlu Kh, Salehi N, Hajnasrollah E, Yegane RA. Surgical management of poisoning by a corrosive arsenic-based depilatory agent. Arch Iranian Med 1999; 2: 77-82.
Vatandoost H, Mirakbari SM. Study of poisoning in adults at poison control center, Loqman-e Hakeem Hospital, Tehran, Iran. Internet J Toxicol 2002; 1(1).
Jalali N, Pajoomand AK, Abdollahi M, Shadnia S. Mortalities due to chemical agents and drugs (1997-1998). J Babol Med 2000; 1(9): 34-41 [in Persian].
Arévalo-Silva C, Eliashar R, Wohlgelernter J, Elidan J, Gross M. Ingestion of caustic substances: a 15-year experience. Laryngoscope 2006; 116(8): 1422-6.
Gumaste VV, Dave PB. Ingestion of corrosive substances by adults. Am J Gastroenterol 1992; 87(1): 1-5.
Zargar SA, Kochhar R, Mehta SK. The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns. Gastrointest Endosc 1991; 37(2): 165-9.
Yeganeh RA, Salehi NA, Hassanian Moghaddam H, Taremi M, Ahmadi M, Sharifi M, et al. Mortality resulting from poisoning with depilatory agent in patients who referred to Loqman Hakim hospital. Sci J Forensic Med of Iran 2006; 12(2): 90-4.
Hojjati M , Saleh M, Osanlou Kh, Salehi N, Hajinasrollah E, Yeganeh RA, et al. Surgical management of poisoning by corrosive arsenic-based Depilatory Agent. Arch Iranian Med 1999; 2(2): 77-82.
. Sarfati E, Gossot D, Assens P, Celerier M. Management of caustic ingestion in adults. Br J Surg 1987; 74: 146 –148.
Tseng YL, Wu MH, Lin MY, Lai WW. Outcome of acid ingestion related aspiration pneumonia. Eur J Cardiothorac Surg 2002; 21(4): 638-43.
Ertekin C, Alimoglu O, Akyildiz H, Guloglu R, Taviloglu K. The results of caustic ingestions. Hepatogastroenterology 2004; 51(59): 1397-400.
Wynne JW, Ramphal R, Hood CI. Tracheal mucosal damage after aspiration. A scanning electron Microscope study. Am Rev Respir Dis 1981; 124(6): 728-32.
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Issue | Vol 47, No 1 (2009) | |
Section | Articles | |
Keywords | ||
Caustic ingestion mortality acid ingestion alkaline ingestion |
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