Alipour Faz Athena, Arsan Fahimeh, Peyvandi Hassan, Oroei Mahbobeh, Shafagh Omid, Peyvandi Maryam, Yousefi Maryam
Clinical Research Development Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
General Surgery Department, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Emerg (Tehran). 2017;5(1):e56. Epub 2017 Feb 2.
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.
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.
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.
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.
腐蚀性物质摄入是中毒暴露最常见的原因之一。本次为期10年的调查旨在评估急诊科收治的腐蚀性物质摄入病例的流行病学特征和结局。
这是一项对2004年至2014年间因腐蚀性物质摄入而入住转诊毒理学中心的患者进行的回顾性横断面研究。记录患者的基线特征、主要主诉、黏膜损伤严重程度、并发症、影像学和实验室检查结果以及结局（入住重症监护病房的需求、手术需求、死亡率），查阅患者的病历资料，并使用SPSS 22进行分析。
共研究了348例患者，平均年龄为37.76±17.62岁（男性占55.6%）。摄入腐蚀性物质的平均量为106.69±100.24毫升（59.2%为故意摄入）。故意摄入（p<0.0001）、酸性物质（p=0.054）和更高的摄入量（p=0.021）与黏膜损伤的更高严重程度显著相关。28例（8%）死亡，53例（15.2%）入住重症监护病房，115例（33%）接受了手术。
自杀意图、更高等级的黏膜损伤、更高的摄入量、更低的意识水平、更低的血清pH值和更高的呼吸频率似乎是入住重症监护病房的需求、手术需求和死亡率的最重要预测因素。
