Open Access Research article

The Role of Age in Predicting the Outcome of Caustic Ingestion in Adults: A Retrospective Analysis

Jui-Min Chang123, Nai-Jen Liu123, Betty Chien-Jung Pai25, Yun-Hen Liu24, Ming-Hung Tsai123, Ching-Song Lee123, Yin-Yi Chu17, Chih-Chuan Lin26, Cheng-Tang Chiu23 and Hao-Tsai Cheng123*

Author Affiliations

1 Division of Digestive Therapeutic Endoscopy, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, Tao-Yuan, Taiwan

2 Chang Gung University College of Medicine, Tao-Yuan, Taiwan

3 Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, Tao-Yuan, Taiwan

4 Thoracic & Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkou Branch, Tao-Yuan, Taiwan

5 Department of Orthodontics and Craniofacial Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan

6 Department of Emergency Medicine, Chang-Gung Memorial Hospital, Taoyuan, Taiwan

7 Department of Gastroenterology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

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BMC Gastroenterology 2011, 11:72  doi:10.1186/1471-230X-11-72

Published: 14 June 2011

Abstract

Background

Although the outcomes of caustic ingestion differ between children and adults, it is unclear whether such outcomes differ among adults as a function of their age. This retrospective study was performed to ascertain whether the clinical outcomes of caustic ingestion differ significantly between elderly and non-elderly adults.

Methods

Medical records of patients hospitalized for caustic ingestion between June 1999 and July 2009 were reviewed retrospectively. Three hundred eighty nine patients between the ages of 17 and 107 years were divided into two groups: non-elderly (< 65 years) and elderly (≥ 65 years). Mucosal damage was graded using esophagogastroduodenoscopy (EGD). Parameters examined in this study included gender, intent of ingestion, substance ingested, systemic and gastrointestinal complications, psychological and systemic comorbidities, severity of mucosal injury, and time to expiration.

Results

The incidence of psychological comorbidities was higher for the non-elderly group. By contrast, the incidence of systemic comorbidities, the grade of severity of mucosal damage, and the incidence of systemic complications were higher for the elderly group. The percentages of ICU admissions and deaths in the ICU were higher and the cumulative survival rate was lower for the elderly group. Elderly subjects, those with systemic complications had the greatest mortality risk due to caustic ingestion.

Conclusions

Caustic ingestion by subjects ≥65 years of age is associated with poorer clinical outcomes as compared to subjects < 65 years of age; elderly subjects with systemic complications have the poorest clinical outcomes. The severity of gastrointestinal tract injury appears to have no impact on the survival of elderly subjects.