Indicators of the Need for Intensive Care Unit Admission in Patients Acutely Exposed to Corrosive Substances with Concern to Endoscopic Assessment, Tanta University Poison Control Center, Egypt | ||
| Egyptian Society of Clinical Toxicology Journal | ||
| Volume 12, Issue 2, December 2024, Pages 172-190 PDF (1.57 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/esctj.2024.343263.1077 | ||
| Authors | ||
| Alshaimma Elmansy* 1; Fatma Gaber Sobeeh2; Norhan Ahmed AbuoHashish3; Amany M Dwidar4; Aliaa Abd Elhakam Hodeib2 | ||
| 1Forensic Medicine and Clinical Toxicology department, Faculty of Medicine, Tanta University, Egypt | ||
| 2Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Egypt. | ||
| 3Pharmacology Department, Faculty of Medicine, Tanta University, Egypt. | ||
| 4Gastroenterology and Hepatology Unit, Internal Medicine Department, Faculty of Medicine, Tanta University, Egypt. | ||
| Abstract | ||
| Background: Acute corrosive poisoning constitutes a significant health concern, characterized by a considerable incidence of severe morbidity and mortality. Aim of the work: This study aimed to identify patterns, potential indicators for the need for intensive care unit (ICU) admission in patients acutely exposed to corrosive substances, and endoscopic findings in patients who developed strictures. Patients and methods: This cross-section study included 70 patients with acute corrosive poisoning admitted to Tanta University Poison Control Center, Egypt, between September 2023 and September 2024. Patients were categorized into ICU-admitted patients and non-ICU-admitted patients. Outcomes were monitored and a gastroendoscopist followed the patients for 3 months. Results: The prevalence of corrosive poisoning was 7.9 % of all poisoned patients while the incidence of ICU admission was 18.6 % of all acute corrosive poisoning. Tachycardia, hypotension, vomiting, respiratory distress, hematemesis, pharyngeal involvement, need for endotracheal intubation, mechanical ventilation, tracheostomy, esophageal stricture, and surgical intervention were significantly high in ICU-admitted patients. In univariate analysis, age, hypotension, vomiting, hematemesis, esophageal stricture, and pharyngeal involvement were significant indicators for ICU admission. In multivariate analysis, esophageal stricture was a significant late indicator of the need for ICU admission. Furthermore, pulse rate, systolic, diastolic and temperature were the most reliable indicators for ICU admission. Conclusions: Patients presenting with vomiting, hematemesis, tachycardia, hypotension, and fever with late presentation of stricture are significant indicators of ICU admission. The incidence of esophageal and/or gastric strictures was 17.1% of the corrosive patients. Upper gastrointestinal endoscopic dilatation is an effective one month post-corrosive exposure. | ||
| Keywords | ||
| corrosive poisoning; intensive care unit; indicator; stricture; endoscope | ||
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