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

Authors
  • Chen, Yu-Jhou1, 2
  • Seak, Chen-June2, 3, 1
  • Chen, Chien-Cheng2, 2, 1
  • Chen, Tsung-Hsing1, 2, 2
  • Kang, Shih-Ching1
  • Ng, Chip-Jin2, 1
  • Lee, Chao-Wei1
  • Su, Ming-Yao2, 3, 4
  • Huang, Hsin-Chih1, 2, 3
  • Ooyang, Chun-Hsiang1
  • Hsieh, Sen-Yung1, 2
  • Cheng, Hao-Tsai1, 2, 2, 3
  • 1 Chang Gung Memorial Hospital, Taoyuan, 33305
  • 2 Chang Gung University, Taoyuan, 33302
  • 3 New Taipei Municipal Tucheng Hospital, New Taipei City, 23652
  • 4 Taiwan Association for the Study of Small Intestinal Disease (TASSID), Taoyuan, 33305
Type
Published Article
Journal
Risk Management and Healthcare Policy
Publisher
Dove
Publication Date
Sep 30, 2020
Volume
13
Pages
1815–1824
Identifiers
DOI: 10.2147/RMHP.S272527
PMID: 33061714
PMCID: PMC7533265
Source
PubMed Central
Keywords
License
Green

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.

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