J Korean Soc Emerg Med.  2015 Dec;26(6):591-597. 10.0000/jksem.2015.26.6.591.

Hematological Parameters Predicting Complications of Caustic Ingestion: A Retrospective Study

• Kim JH
• Park JM
• Kim MJ
• Kim KH
• Park JS
• Shin DW
• Kim H
• Jeon WC
• Kim HJ

• KMID: 2191672
• DOI: http://doi.org/10.0000/jksem.2015.26.6.591

Abstract

PURPOSE
In addition to chemical burn of the alimentary tract, caustic ingestion can cause severe complications including esophageal perforation, airway edema, esophageal stricture, and death. Hematological parameters have been reported to be useful inflammatory markers predicting prognoses in various clinical situations where oxidative stress is increased. We hypothesized that hematological parameters might be useful for prediction of complications after caustic ingestion.
METHODS
We performed a retrospective analysis of patients admitted to our Emergency Department after caustic ingestion. The numbers of leukocytes, neutrophils, lymphocytes, and monocytes, and the neutrophil-lymphocyte ratio were compared between uncomplicated and complicated patient groups. Receiver operating characteristic curve analysis was performed for parameters that differed between the two groups. Subgroup analysis was performed according to the substance ingested, thus acid or alkali.
RESULTS
Thirty-seven patients were included in our study and eight had complications. Leukocyte, neutrophil counts, and the neutrophil-lymphocyte ratio of the complicated group were higher than those of the uncomplicated group. The areas under the receiver operating characteristic curves of leukocyte counts, neutrophil counts, and the neutrophil- lymphocyte ratio, were 0.819, 0.832, and 0.750, respectively. The cut-off values of these parameters for prediction of complications were 12 060/uL, 9607/uL, and 2.72, respectively. In subgroup analysis, the leukocyte and neutrophil counts, and the neutrophil-lymphocyte ratio of complicated patients who had ingested alkali were higher than those of the uncomplicated group.
CONCLUSION
Leukocyte counts, neutrophil counts, and the neutrophil-lymphocyte ratio might serve as useful predictors of complications after ingestion of caustic substances.

Keyword

Blood cell count; Caustics; Esophagus; Wounds and injuries

MeSH Terms

Alkalies
Blood Cell Count
Burns, Chemical
Caustics
Eating*
Edema
Emergency Service, Hospital
Esophageal Perforation
Esophageal Stenosis
Esophagus
Humans
Leukocyte Count
Leukocytes
Lymphocytes
Monocytes
Neutrophils
Oxidative Stress
Prognosis
Retrospective Studies*
ROC Curve
Wounds and Injuries
Alkalies
Caustics