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Can we predict the risk of esophageal stricture after caustic injury?
Zerbib, Philippe; Lailheugue, Aurore; Labreuche, Julien; Richa, Yasmina; Cailliau, Emeline; Onimus, Thierry; Valibouze, Caroline.
Afiliação
  • Zerbib P; Department of Digestive Surgery and Transplantation, University Hospital of Lille Nord de France, Lille, France.
  • Lailheugue A; Department of Digestive Surgery and Transplantation, University Hospital of Lille Nord de France, Lille, France.
  • Labreuche J; Department of Biostatistics, University Hospital of Lille Nord de France, Lille, France.
  • Richa Y; Department of Digestive Surgery and Transplantation, University Hospital of Lille Nord de France, Lille, France.
  • Cailliau E; School of Medicine, University College Cork, Cork, Ireland.
  • Onimus T; Department of Biostatistics, University Hospital of Lille Nord de France, Lille, France.
  • Valibouze C; Department of Intensive Care Medicine, Critical Care Center, University Hospital of Lille Nord de France, Lille, France.
Dis Esophagus ; 37(5)2024 Apr 27.
Article em En | MEDLINE | ID: mdl-38282020
ABSTRACT
Nonoperative management of severe caustic injuries has demonstrated its feasibility, avoiding the need for emergency esogastric resection and resulting in low mortality rates. However, leaving superficial necrosis in place could increase the risk of esophageal stricture development. Data on the risk factors of esophageal stricture secondary to caustic ingestion are scarce. The aim of our study was to identify the risk factors for esophageal strictures after caustic ingestion at admission. From February 2015 to March 2021, all consecutive patients with esophageal or gastric caustic injury score ≥ II according to the Zargar classification were retrospectively analyzed. For each patient, we collected over 50 criteria at admission to the emergency room and then selected among them 20 criteria with the best clinical relevance and limited missing data for risk factor analyses. Among the 184 patients included in this study, 37 developed esophageal strictures (cumulative rate 29.4%). All esophageal strictures occurred within 3 months. In multivariate analyses, the risk factors for esophageal strictures were voluntary ingestion (cause-specific hazard ratio 5.92; 95% confidence interval 1.76-19.95, P = 0.004), Zargar's esophageal score ≥ III (cause-specific hazard ratio 14.30; 95% confidence interval 6.07-33.67, P < 0.001), and severe ear, nose, and throat lesions (cause-specific hazard ratio 2.15; 95% confidence interval 1.09-4.22, P = 0.027). Intentional ingestion, severe endoscopic grade, and severe ENT lesions were identified as risk factors for esophageal stricture following caustic ingestion. Preventive measures for this population require further evaluation.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Queimaduras Químicas / Cáusticos / Estenose Esofágica Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Dis Esophagus Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: França

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Queimaduras Químicas / Cáusticos / Estenose Esofágica Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Dis Esophagus Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: França