. 2020 Sep 30:13:1815-1824.

doi: 10.2147/RMHP.S272527. eCollection 2020.

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

Yu-Jhou Chen^#^{1

2}, Chen-June Seak^#^{2

3

4}, Chien-Cheng Chen^{2

5

6}, Tsung-Hsing Chen^{1

2

5}, Shih-Ching Kang⁷, Chip-Jin Ng^{2

4}, Chao-Wei Lee⁸, Ming-Yao Su^{2

9

10}, Hsin-Chih Huang^{1

2

9}, Chun-Hsiang Ooyang⁷, Sen-Yung Hsieh^{1

2}, Hao-Tsai Cheng^{1

2

5

9}

Affiliations

¹ Department of Gastroenterology and Hepatology, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan.
² College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
³ Department of Emergency Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City 23652, Taiwan.
⁴ Department of Emergency Medicine, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan.
⁵ College of Medicine, Graduate Institute of Clinical Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
⁶ Department of Medical Image and Intervention, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan.
⁷ Division of Trauma and Emergent Surgery, Department of Surgery, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan.
⁸ Division of General Surgery, Department of Surgery, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan.
⁹ Department of Gastroenterology and Hepatology, Department of Internal Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City 23652, Taiwan.
¹⁰ Board of Directors and Supervisors, Taiwan Association for the Study of Small Intestinal Disease (TASSID), Taoyuan 33305, Taiwan.

^# Contributed equally.

PMID: 33061714
PMCID: PMC7533265
DOI: 10.2147/RMHP.S272527

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

Yu-Jhou Chen et al. Risk Manag Healthc Policy. 2020.

. 2020 Sep 30:13:1815-1824.

doi: 10.2147/RMHP.S272527. eCollection 2020.

Authors

Affiliations

¹ Department of Gastroenterology and Hepatology, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan.
² College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
³ Department of Emergency Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City 23652, Taiwan.
⁴ Department of Emergency Medicine, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan.
⁵ College of Medicine, Graduate Institute of Clinical Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
⁶ Department of Medical Image and Intervention, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan.
⁷ Division of Trauma and Emergent Surgery, Department of Surgery, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan.
⁸ Division of General Surgery, Department of Surgery, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan.
⁹ Department of Gastroenterology and Hepatology, Department of Internal Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City 23652, Taiwan.
¹⁰ Board of Directors and Supervisors, Taiwan Association for the Study of Small Intestinal Disease (TASSID), Taoyuan 33305, Taiwan.

^# Contributed equally.

PMID: 33061714
PMCID: PMC7533265
DOI: 10.2147/RMHP.S272527

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; complications; corrosive; endoscopy; long-term survival; psychiatric.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

**Figure 1**
Enrollment diagram for the study population (n=396) and control group (n=377).

**Figure 2**
Urgent EGD grading for patients with each specific PC.

**Figure 3**
Overall survival analyses with the Kaplan–Meier method. (A) ETT + MV during EGD (p<0.001); (B) Age (p=0.002); (C) GI complication (p<0.001).

See this image and copyright information in PMC

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References

1. Hoffman R, Burns M, Gosselin S, Longo DL. Ingestion of caustic substances. N Engl J Med. 2020;382(18):1739–1748. doi:10.1056/NEJMra1810769 - DOI - PubMed
1. Hall AH, Jacquemin D, Henny D, Mathieu L, Josset P, Meyer B. Corrosive substances ingestion: a review. Crit Rev Toxicol. 2019;49(8):637–669. doi:10.1080/10408444.2019.1707773 - DOI - PubMed
1. Cheng H-T, Cheng C-L, Lin C-H, et al. Caustic ingestion in adults: the role of endoscopic classification in predicting outcome. BMC Gastroenterol. 2008;8(1):31. doi:10.1186/1471-230X-8-31 - DOI - PMC - PubMed
1. Chen C-M, Chung Y-C, Tsai L-H, et al. A nationwide population-based study of corrosive ingestion in Taiwan: incidence, gender differences, and mortality. Gastroent Res Pract. 2016;2016:7905425. - PMC - PubMed
1. Ramasamy K, Gumaste VV. Corrosive ingestion in adults. J Clin Gastroenterol. 2003;37(2):119–124. doi:10.1097/00004836-200308000-00005 - DOI - PubMed

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

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

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