The Association Between Caustic Ingestion and Psychiatric Comorbidity Based on 396 Adults Within 20 Years

Abstract

Purpose

High prevalence of psychiatric comorbidities (PCs) has been widely documented in caustic substance ingestion cases. However, their effect on the clinical features and prognostic outcomes remains unclear due to the paucity of discussion. We report on detailed clinical courses with long-term multifaceted outcomes and review the association between caustic ingestion and each specific PC.

Patients and Methods

The retrospective chart review included 396 adults (median follow-up, 16.6 months) with and 377 without (control group) PCs treated between 1999 and 2018 at Chang Gung Memorial Hospital. All PCs were diagnosed/confirmed by psychiatrists through face-to-face interviews.

Results

The PCs predicted serious esophagogastroduodenoscopy grading, higher rates of admission/surgery/intensive care unit stay, increments of systemic/gastrointestinal complications, and poorer 5-year overall survival rates. The poor survival among patients with PCs was highly consistent with their baseline characteristics. Significantly advanced age, more non-PCs, alcoholism, illicit drug abuse, and baseline unhealthy status resulted in statistically higher risks of severe complications and limited recovery.

Conclusion

PCs changed clinical patterns and had critical roles in the survival outcomes of caustic injury victims. Clinical awareness achieves benefit by limiting injuries in mild cases or allowing emergent interventions in severe cases. Future studies based on worldwide populations are essential for realizing geographic differences.

Keywords:

• caustic
• corrosive
• psychiatric
• endoscopy
• complications
• long-term survival

Acknowledgments

Thanks for all the colleagues from the Department of Gastroenterology and Hepatology, Department of Psychiatry, Department of Emergency Medicine, Department of Medical Image and Intervention, Division of Trauma and Emergent Surgery, and Division of General Surgery of Linkou Medical Center, Chang Gung Memorial Hospital to help us caring the patients.

Ethics

Our research protocol had been approved by Chang Gung Medical Foundation Institutional Review Board (IRB number: 202000583B0; executing institution: Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan). The IRB reviewed and determined that it is expedited review according to personal information, data, documents, or specimens collected from legal biological databases without hyperlink or identifiable information that can be used for research but cannot be involved in the interests of individuals or groups. On the basis of the aforementioned statements, the IRB approves the waiver of the participants’ consent in the present study.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported by grants from Linkou Chang Gung Memorial Hospital Research Project: Grant CMRPG3F1931 to Dr. Hao-Tsai Cheng. The funding source had no role in the study’s design, conduct, or reporting. The contents do not represent the views of Linkou Chang Gung Memorial Hospital.