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
Elmansy, A., Sobeeh, F., AbuoHashish, N., Dwidar, A., Hodeib, A. (2024). 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. EKB Journal Management System, 12(2), 172-190. doi: 10.21608/esctj.2024.343263.1077
Alshaimma Elmansy; Fatma Gaber Sobeeh; Norhan Ahmed AbuoHashish; Amany M Dwidar; Aliaa Abd Elhakam Hodeib. "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". EKB Journal Management System, 12, 2, 2024, 172-190. doi: 10.21608/esctj.2024.343263.1077
Elmansy, A., Sobeeh, F., AbuoHashish, N., Dwidar, A., Hodeib, A. (2024). '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', EKB Journal Management System, 12(2), pp. 172-190. doi: 10.21608/esctj.2024.343263.1077
Elmansy, A., Sobeeh, F., AbuoHashish, N., Dwidar, A., Hodeib, A. 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. EKB Journal Management System, 2024; 12(2): 172-190. doi: 10.21608/esctj.2024.343263.1077

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, Page 172-190  XML PDF (1.57 MB)
Document Type: Original Article
DOI: 10.21608/esctj.2024.343263.1077
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Authors
Alshaimma Elmansy email orcid 1; Fatma Gaber Sobeeh2; Norhan Ahmed AbuoHashishorcid 3; Amany M Dwidar4; Aliaa Abd Elhakam Hodeiborcid 2
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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