The Role of Age in Predicting the Outcome of Caustic Ingestion in Adults: A Retrospective Analysis

Abstract

BackgroundAlthough the outcomes of caustic ingestion differ between children and adults, it is unclear whether such outcomes differ among adults as a function of their age. This retrospective study was performed to ascertain whether the clinical outcomes of caustic ingestion differ significantly between elderly and non-elderly adults.MethodsMedical records of patients hospitalized for caustic ingestion between June 1999 and July 2009 were reviewed retrospectively. Three hundred eighty nine patients between the ages of 17 and 107 years were divided into two groups: non-elderly (< 65 years) and elderly (≥ 65 years). Mucosal damage was graded using esophagogastroduodenoscopy (EGD). Parameters examined in this study included gender, intent of ingestion, substance ingested, systemic and gastrointestinal complications, psychological and systemic comorbidities, severity of mucosal injury, and time to expiration.ResultsThe incidence of psychological comorbidities was higher for the non-elderly group. By contrast, the incidence of systemic comorbidities, the grade of severity of mucosal damage, and the incidence of systemic complications were higher for the elderly group. The percentages of ICU admissions and deaths in the ICU were higher and the cumulative survival rate was lower for the elderly group. Elderly subjects, those with systemic complications had the greatest mortality risk due to caustic ingestion.ConclusionsCaustic ingestion by subjects ≥65 years of age is associated with poorer clinical outcomes as compared to subjects < 65 years of age; elderly subjects with systemic complications have the poorest clinical outcomes. The severity of gastrointestinal tract injury appears to have no impact on the survival of elderly subjects.

Computed tomography evaluation of high-grade esophageal necrosis after corrosive ingestion to avoid unnecessary esophagectomy

“…We then used a multivariable Cox model to compare survival after adjustment on prognostic co-variates. We individually matched patients from the two groups (CT or no CT) on age (±2 years) [16,31], gender [16,32], and acid ingestion [6,16,33] then compared survival using a Cox model with a random effect on the pairs. All tests were two-sided at the 0.05 significance level.…”

The Role of Second-look Endoscopy in Severe Esophageal Caustic Injury

“…Unlike caustic ingestion in children, adults usually ingest strong corrosives with suicidal intent and lead to severe, life-threatening injuries with multiple long-term complications, including stricture, fistula formation and malignancy [7,15]. In the study, we found most caustic injury adults were also suicide intent with acid caustic agents (detergent or insecticides) at middle to older age in Taiwan.…”

Upper Digestive Tract Reconstruction for Caustic Injuries

“…At the end of the followup period, 1 patient (1%) in the esophagocoloplasty group and 17 patients (16%) in the colopharyngoplasty group had a tracheotomy tube (P < 0.0001). The median delay in jejunostomy removal was 3 [2][3][4][5] months after esophagocoloplasty and 9 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] months after colopharyngoplasty (P < 0.0001).…”