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Caustic ingestion. Spanish multicenter study on prognostic severity factors and diagnostic test performance
María Codinach-Martín1, Antonio Francisco Caballero-Bermejo2, María Teresa Maza-Vera3
1Servicio de Urgencias, Hospital Doctor Josep Trueta, Girona, España.
Summary
Patients with oral caustic injury have worse outcomes when ingestion is intentional or involves corrosive agents like ammonia. Initial symptoms and diagnostic tests like esophagogastroduodenoscopy (EGD) help predict severity, though computed tomography (CT) has limitations.
Area of Science:
- Emergency Medicine
- Gastroenterology
- Toxicology
Background:
- Oral caustic injury is a significant clinical problem often managed in emergency departments (EDs).
- Understanding factors influencing severity and prognosis is crucial for effective patient management.
Purpose of the Study:
- To characterize the clinical profile of patients treated for oral caustic injury.
- To describe diagnostic test utilization in EDs.
- To analyze factors associated with injury severity and patient prognosis.
Main Methods:
- A multicenter, retrospective, observational study was conducted over seven years (2015-2021).
- Data from 225 patients treated in EDs for caustic substance ingestion were analyzed.
- The prognostic performance of esophagogastroduodenoscopy (EGD) and computed tomography (CT) was evaluated.
Main Results:
- Intentional ingestion (49.3%), sodium hypochlorite, and hydrochloric acid were common causes.
- Prognostic factors for severe injury included intentional ingestion (OR 4.19), ammonia ingestion (OR 11.39), and initial symptoms.
- CT showed acceptable performance for severe lesions but does not replace EGD in less severe cases.
Conclusions:
- Suicidal intent, highly corrosive agents, and initial clinical presentation correlate with poorer outcomes.
- Computed tomography (CT) is valuable but does not substitute for esophagogastroduodenoscopy (EGD) in mild to moderate cases.
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