METHODS: This retrospective study, which took place at 14 hospitals in three countries evaluated all patients who presented with a caustic ingestion between 2014-2020. The presence of symptoms and esophageal injury, demographic information, pH of ingested substance, reason for the ingestion, and outcome were recorded.
RESULTS: 409 patients were identified; 203 (46.9%) were male. The median (IQR) age was 18 (4-31) years; overall range 10 months to 78 years. Suicidal ingestions accounted for 155 (37.9%) of cases. Dysphagia or dysphonia were more likely in those with significant esophageal injury compared to those without (59.3% vs. 12.6% respectively; OR 10.1; 95% CI 4.43-23.1). Among 27 patients with significant esophageal injury, 48% were found in suicidal patients, compared with 51.9% in non-suicidal patients (p = NS). On multivariate regression, there was no difference in the rate of significant esophageal injury among suicidal vs. non suicidal patients (aOR 1.55; p = 0.45, 95% CI 0.45-5.33). Most ingestions involved basic substances (332/409; 81.2%). Unknown or mixed ingestions accounted for 25 (6.11%) of the ingestions. Significant esophageal burns were found in 6/52 (11.5%) of acid ingestions, compared with 21/332 (6.3%) of basic ingestions. Of the 42 cases of acidic ingestions without dysphagia or odynophagia, 2 (4.8%; 0.58-16.1%) had significant esophageal burns, compared with 9 (3.2%; 95% CI 1.4-5.9%) of the 284 basic ingestions; p = 0.64). On multivariate logistic regression, patients with acidic ingestions were not more likely to experience a significant burn (aOR 1.7; p = 0.11, 95% CI 0.9-3.1) compared to those with basic ingestions. No patient with significant esophageal burns was asymptomatic.
CONCLUSIONS: In this study, there was no statistical differences in the rates of significant burns between acidic and basic caustic ingestions. There were no significant esophageal injuries noted among asymptomatic patients.
方法:本回顾性研究,这项研究在三个国家的14家医院进行,评估了2014-2020年间所有出现腐蚀性摄入的患者。症状和食道损伤的存在,人口统计信息,摄入物质的pH值,摄入的原因,并记录结果。
结果:409例患者中,203例(46.9%)为男性。中位(IQR)年龄为18(4-31)岁;总体范围为10个月至78岁。自杀摄入占155例(37.9%)。与没有明显食管损伤的患者相比,吞咽困难或发音困难的可能性更大(59.3%vs.分别为12.6%;OR10.1;95%CI4.43-23.1)。在27例严重食管损伤患者中,48%的人被发现有自杀倾向,非自杀患者为51.9%(p=NS)。关于多元回归,自杀与自杀之间的明显食道损伤率没有差异。非自杀患者(aOR1.55;p=0.45,95%CI0.45-5.33)。大多数摄入涉及碱性物质(332/409;81.2%)。未知或混合摄入占摄入的25(6.11%)。在6/52(11.5%)的酸摄入中发现明显的食管灼伤,与21/332(6.3%)的基本摄入相比。在42例无吞咽困难或吞咽困难的酸性摄入中,2例(4.8%;0.58-16.1%)有明显的食道烧伤,与284例基本摄入中的9例(3.2%;95%CI1.4-5.9%)相比;p=0.64)。在多元逻辑回归中,与有基本摄入的患者相比,有酸性摄入的患者更不可能出现显著烧伤(aOR1.7;p=0.11,95%CI0.9-3.1).无明显食管烧伤患者无症状。
结论:在这项研究中,酸性和碱性苛性碱摄入之间的显著烧伤率没有统计学差异。无症状患者中没有明显的食管损伤。