Acta Medica Iranica (Apr 2009)
Investigation of Mortality after Corrosive Ingestion: a Prospective Study
Abstract
Ingested corrosive substances produce different injuries, ranging from minor gastro esophageal burns to death, depending on the agent type, amount, concentration, and duration of substance exposure. The purpose of this study was to investigate the outcomes and different causes of mortality in patients ingesting caustic substances. In a prospective study, between April 1999 and January 2006, a total of 1260 patients with a history of caustic agent ingestion were admitted to Loqman-Hakim hospital emergency ward. Patients who died despite our management were included in this study. Mortality rate was stratified as early (during the primary hospitalization) and delayed (after discharge from the hospital) based on the etiologies. Sixty-two patients died during follow up. Among patients who died, mean arrival time to the hospital was 12 hours from exposure, ranging from 30 minutes to 120 hours. Aspiration and airway obstruction were the leading causes of mortality accounting for 25 patients' death. Twenty-seven of them underwent surgical intervention, among whom 21 deaths occurred after early operations and 6 deaths after delayed reconstructive surgery. In cases of caustic ingestion, early admission and airway protection besides surgical intervention, if indicated, can reduce the mortality rate.