Predictors of severity of corrosive injury

Author: 
Neeraj Nagaich, Radha Sharma, Sandeep Nijhawan, Sheetal Nepalia, Yashvardhan and Monika Rathore

Objective: To evaluate clinical and biochemical predictor and role of a 6-point EGD classification system of injury in predicting outcomes in patients diagnosed with caustic agent ingestion.

Material and Methods: 91 patients admitted to SMS hospital Jaipur, with definite caustic ingestion between 2010-2012 were evaluated prospectively. Detailed history, physical examination, biochemical, radiological and endoscopic evaluation was done in all patients at the time of admission and during a follow up period of 6 month. Patients were given standard care treatment during this period depending on severity of disease.

Results: Endoscopic grading wast most accurate predictor. Voluntary ingestion, vomiting, drooling, stridor and abdominal tenderness were associated with the severity of injury. Leucocytosis, low pH, low phosphorus and alkaline phosphatase level, and high uric acid were significantly associated with severe injury.

Conclusions: Serious signs and symptoms (vomiting, drooling, and stridor) had serious esophageal injury. Leucocytosis, low pH, low phosphorus and alkaline phosphatase level, and high uric acid also predict severity of injury. Best predictor of injury is endoscopic grading.

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