Abstract
Caustic poisonings are still associated with many fatalities. Studies focusing on the elderly are rare. The purpose of the present study was to compare the clinical outcomes of caustic ingestion injury in elderly and non-elderly adults with regard to gender, intent of exposure, substance ingested, severity of mucosal injury, complications, and mortality. Caustic substance exposures reported to the National Toxicological Information Centre in Slovakia during 1998–2015 were reviewed retrospectively. The patients were divided into two groups: the non-elderly (<60 years) and elderly adults (≥60 years). The mortality rate in the elderly was significantly higher (elderly 23.0% vs. non-elderly 11.3%; p = 0.041). The risk of fatal outcome in the elderly was increased by acid ingestion (OR = 7.822; p = 0.002), particularly hydrochloric acid (OR = 5.714, p = 0.006). The incidence of respiratory complications was almost two times higher in the elderly was 31.1% vs. 17.4% for the non-elderly (p = 0.037). Respiratory complications significantly correlated with an increased mortality rate (p = 0.001) in the elderly whereas there was no association between GI complications and mortality in the elderly (p = 0.480). Elderly patients with respiratory complications had the poorest clinical outcomes. The highest risk of complications and fatalities was observed in patients after hydrochloric acid ingestion.
Highlights
Caustic poisonings pose a serious problem for healthcare providers due to high morbidity and mortality
We retrospectively reviewed all caustic substance exposures that were the subject of inquiries to the National Toxicological Information Centre (NTIC) in Slovakia between January 1998 and December
Our 18-year study confirmed that mortality after caustic ingestion is significantly higher in the elderly compared to younger adults
Summary
Caustic poisonings pose a serious problem for healthcare providers due to high morbidity and mortality. Chemicals and chemical products stored in homes are the source of many accidental or intentional exposures that can be seen in people of different ages [1]. Caustic ingestion contribute to frequent causes of inquiries to the National Toxicological Information Centre (NTIC) in Slovakia [2]. Diluted acids or alkalis usually induce limited mucosal damage. Concentrated caustic agents with pH 12 can result in severe esophageal damage with either colliquative (alkali) or coagulative necrosis (acids) and, at the same time, a wide range of gastrointestinal injuries which can lead to late post-corrosive complications [3,4,5,6]. From the toxicological point of view, pH often fails to predict the extent of injury after exposure and reliance on pH alone might result in clinical errors in patient management. The determined pH value must be taken into account with other physical-chemical parameters, e.g., viscosity, physical form, Molecules 2017, 22, 1726; doi:10.3390/molecules22101726 www.mdpi.com/journal/molecules
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
