Predicting Factors of Inpatient Outcome After Non-Hemorrhagic Endoscopic Urgencies: The Experience of a Tertiary Center on Esophageal Foreign Body or Caustic Injuries

Aims Ingestion of foreign bodies (FB) or caustic agents (CA) are frequent non-hemorrhagic causes of endoscopic urgencies, with potential for severe complications. We aimed to evaluate clinical, endoscopic and imaging predictors of inpatient outcomes in patients hospitalized after FB or CA ingestion.

Methods Retrospective study of patients admitted between 2000 and 2019 at a tertiary center after FB or CA ingestion. Clinical data, as well as lab values at admission, endoscopic and CT findings were evaluated and their correlation with variables of inpatient outcome, including length of stay (LS), was measured.

Results Sixty-six patients were included (44 FB and 22 CA), 64 % were male. Mean age was 56 years. Median LS was 7 days, without differences between the groups (p = 0.07). Admission C reactive protein (CRP) value correlated with LS in the FB group (p < 0.01), but not in CA. Over 90 % of patients underwent endoscopy. It was performed < 24 hours after presentation in 77 %. Lesions were more common in upper and mid-esophagus in FB patients; pan-esophageal involvement occurred in 65 % of CA patients. In FB patients, diagnosis of perforation on both endoscopy (p = 0.02) and CT scan (p < 0.01) was correlated with LS. Endoscopic Zargar classification of caustic lesions did not significantly correlate with LS in CA patients (p = 0.36). However, moderate-to-severe lesions (Zargar ≥ 2B) correlated with need of intensive care treatment (p = 0.02), antibiotics (p = 0.01) and nosocomial pneumonia (p = 0.03). Severity of caustic lesions on CT scan did not correlate with LS.

Tab.1

	Length of stay Foreign body group	Length of stay Caustic agents group
C reactive protein, ρ (p)	0.542 (< 0.01)	0.180 (0.435)
Zargar, ρ (p)	n. a.	0.221 (0.362)
Perforation, ρ (p)	0.628 (< 0.01)	0.406 (0.149)
CT severity, ρ (p)	n. a.	0.360 (0.207)

Conclusions In patients admitted for FB, CRP values mal help stratify the probability of complications. Also, diagnosis of perforation in these patients is associated with worse inpatient outcomes. In CA patients, Zargar classification may help to predict inpatient complications, but does not correlate with LS.

Citation: Ribeiro T, Mascarenhas Saraiva M, Brozzi L et al. eP53 PREDICTING FACTORS OF INPATIENT OUTCOME AFTER NON-HEMORRHAGIC ENDOSCOPIC URGENCIES: THE EXPERIENCE OF A TERTIARY CENTER ON ESOPHAGEAL FOREIGN BODY OR CAUSTIC INJURIES. Endoscopy 2021; 53: S114.

Publication History

Article published online:
19 March 2021