Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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Comparison of Clinical Characteristics and Prognosis by Initial Endoscopic Severity in Caustic Injury

부식제 음독 환자에서 초기 내시경 소견의 중증도에 따른 임상 소견 및 예후 비교

  • Lee, Sang Min (Department of Emergency Medicine, School of Medicine, Keimyung University, Dongsan Medical center) ;
  • Choi, Woo Ik (Department of Emergency Medicine, School of Medicine, Keimyung University, Dongsan Medical center) ;
  • Kim, Sung Jin (Department of Emergency Medicine, School of Medicine, Keimyung University, Dongsan Medical center) ;
  • Jin, Sang Chan (Department of Emergency Medicine, School of Medicine, Keimyung University, Dongsan Medical center)
  • 이상민 (계명대학교 의과대학 동산의료원 응급의학교실) ;
  • 최우익 (계명대학교 의과대학 동산의료원 응급의학교실) ;
  • 김성진 (계명대학교 의과대학 동산의료원 응급의학교실) ;
  • 진상찬 (계명대학교 의과대학 동산의료원 응급의학교실)
  • Received : 2015.06.19
  • Accepted : 2015.08.19
  • Published : 2015.12.31
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Abstract

Purpose: We investigated comparison of clinical characteristics and prognosis by initial endoscopic severity in caustic injury and then discussed predisposing factors which can be helpful in predicting the prognosis and determining the treatment. Methods: This study was a retrospective review of medical records from patients over the age of 15, who underwent initial endoscopy for caustic injury from April 2007 through November 2014. Patients were classified according to two groups based on the initial endoscopic finding by Zargar's classification: patients with grade 0, I, IIa at esophagus (low risk group) and patients with grade IIb, IIIa, IIIb at esophagus (high risk group). The two groups were then compared. Results: A total of 55 patients were included (low risk group [n=44] vs. high risk group [n=11]). Old age (p<0.001), large amount of ingestion (p<0.05), oropharyngeal symptoms (p<0.01), high SOFA score (p<0.001), high WBC count (p<0.05), low base excess (p<0.01), and HCO3 (p<0.05) were statistically significant factors in the high risk group. A poor prognosis was observed for hospital stay (p<0.001), ICU admission (p<0.001), mortality (p<0.01), and stricture (p<0.001) in the high risk group. Conclusion: Clinical characteristics including age, amount of ingestion, oropharyngeal symptoms, SOFA score, WBC count, base excess, and $HCO_3$ can be helpful in the decision to undergo initial endoscopy and risk assessment by initial endoscopic severity can be helpful in predicting prognosis and determining the treatment plan.

Keywords

References

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