Mahmoud, A., Mohammed, E., Al Husseini, R., Bilal, S. (2019). Risk Factors Predicting Stricture Formation and Death in Patients with Caustic Ingestion. test, 32(1), 10-19. doi: 10.21608/ajfm.2019.23377
Alaa Mahmoud; Eman Mohammed; Rasha Al Husseini; Sana Bilal. "Risk Factors Predicting Stricture Formation and Death in Patients with Caustic Ingestion". test, 32, 1, 2019, 10-19. doi: 10.21608/ajfm.2019.23377
Mahmoud, A., Mohammed, E., Al Husseini, R., Bilal, S. (2019). 'Risk Factors Predicting Stricture Formation and Death in Patients with Caustic Ingestion', test, 32(1), pp. 10-19. doi: 10.21608/ajfm.2019.23377
Mahmoud, A., Mohammed, E., Al Husseini, R., Bilal, S. Risk Factors Predicting Stricture Formation and Death in Patients with Caustic Ingestion. test, 2019; 32(1): 10-19. doi: 10.21608/ajfm.2019.23377

Risk Factors Predicting Stricture Formation and Death in Patients with Caustic Ingestion

Ain Shams Journal of Forensic Medicine and Clinical Toxicology
Article 2, Volume 32, Issue 1, January 2019, Pages 10-19    PDF (247.88 K)
DOI: 10.21608/ajfm.2019.23377
Authors
Alaa Mahmoud; Eman Mohammed; Rasha Al Husseini; Sana Bilal
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Abstract
Background: Caustic ingestion is still a difficult medical problem, and the outcome is often unexpected. Objectives: This study assessed the usefulness of intoxication data, clinical data and some laboratory parameters in predicting the outcome following caustic ingestion, and test the applicability of DROOL Score (DS) as a prognostic indicator of oesophageal stricture. Methods: Ninety-two patients with caustic ingestion admitted to Poison Control Centre Ain Shams University (PCCASU), during the period from 1st June to November 30, 2015 were prospectively studied. Diagnoses of stricture made via barium study. Results: Sixty-six percentage of cases were children under 5 years. In 48.9% of cases, the caustic agent was alkaline. Symptoms and signs can adequately predict the outcome of corrosive patients. DROOL Score and Total Leucocytic Count (TLC) ≥ 20,000 are useful tools for predicting both stricture formation and mortality, in addition blood pH ˂ 7.2 can also predict mortality.  A new value of DS ≤ 5.5 to predict stricture formation and mortality of corrosive patients was proposed. Conclusion: Clinical manifestations can adequately predict the outcome also; DS and TLC ≥ 20,000 have predictive value for outcome prediction of corrosive patients. Moreover, blood pH ˂ 7.2 can predict mortality.  A new value of DS ≤ 5.5 was identified as a prognostic indicator of outcome in caustic patients. 
Keywords
Corrosive; Outcome; poison centres; stricture; Prognostic factors
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