title: [Study of predictive factors of severe digestive lesions due to caustics ingestion].
abstract: OBJECTIVE
  Our purpose was to analyze the predictive factors of severe upper gastrointestinal injury by caustic substances in adult patients.
  
  
  METHODS
  Retrospective study between February 1995 and February 2001 of adult patients who underwent an urgent upper endoscopy due to caustic ingestion. Endoscopic caustic ingestion criteria by Zargar et al were used to determine the degree of injury. We performed a univariate study of factors associated with sever digestive injury and, lately, a logistic regression analysis of predictive factors. Sensitivity, specificity, positive and negative predictive values of these factors were calculated.
  
  
  RESULTS
  One hundred and fifty nine patients were included in the study, whose mean age was 48.9 (20.1) years and 49.7% were men. The more frequent caustic ingested was lye (47.8%). A severe caustic injury was found in urgent upper endoscopy in 18.4% of patients, which was located in esophagus in 14.6%, stomach in 8.2% and duodenum in 0.6% of cases. Male sex, voluntary ingestion, oropharingeal lesions, significant clinical symptoms and dishwasher and detergents ingestion were associated with severe upper gastrointestinal tract (GIT) injury. Voluntary ingestion, oropharingeal lesions and significant clinical symptoms at admission were independent predictive factors of severe GIT injury. The existence of one of these factors had an 89.7% of sensitivity while two or more displayed a specificity of 91%.
  
  
  CONCLUSIONS
  Clinical and exploratory data may determine, before upper endoscopic procedure, the probability of severe GIT injury by caustic ingestion. Therefore, these data could play a significant role in the diagnostic, prognostic and therapeutic management of caustic ingestion.
authors.affiliation: Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Madrid, Spain. onumar@inicia.es
authors.forename: Oscar
authors.initials: O
authors.lastname: Núñez
authors.forename: Cecilia
authors.initials: C
authors.lastname: González-Asanza
authors.forename: Gema
authors.initials: G
authors.lastname: de la Cruz
authors.forename: Gerardo
authors.initials: G
authors.lastname: Clemente
authors.forename: Rafael
authors.initials: R
authors.lastname: Bañares
authors.forename: Enrique
authors.initials: E
authors.lastname: Cos
authors.forename: Pedro
authors.initials: P
authors.lastname: Menchén
mesh_terms: D000328:Adult; D002057:Burns, Chemical / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002424:Caustics / Q000009:adverse effects; D016145:Endoscopy, Digestive System; D004935:Esophageal Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D041742:Upper Gastrointestinal Tract / Q000473:pathology*
chemical_list: D002424:Caustics