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Journal of The Korean Society of Emergency Medicine 2015;26(6): 591-597. |
Hematological Parameters Predicting Complications of Caustic Ingestion : A Retrospective Study |
Jun Hyung Kim1, Joon Min Park1, Min Joung Kim2, Kyung Hwan Kim1, Jun Seok Park1, Dong Wun Shin1, Hoon Kim1, Woo Chan Jeon1, Hyun Jong Kim1 |
1Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Gyeonggido, Korea 2Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea |
Correspondence |
Joon Min Park ,Tel: 031) 910-7119, Fax: 031) 910-7188, Email: aero7@paik.ac.kr,
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Received: June 29, 2015; Revised: June 30, 2015 Accepted: October 1, 2015. Published online: December 30, 2015. |
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ABSTRACT |
Purpose: In addition to chemical burn of the alimentary tract, caustic ingestion can cause severe complications including esophageal perforation, airway edema, esophageal stricture, and death. Hematological parameters have been reported to be useful inflammatory markers predicting prognoses in various clinical situations where oxidative stress is increased. We hypothesized that hematological parameters might be useful for prediction of complications after caustic ingestion.
Method: We performed a retrospective analysis of patients admitted to our Emergency Department after caustic ingestion. The numbers of leukocytes, neutrophils, lymphocytes, and monocytes, and the neutrophil-lymphocyte ratio were compared between uncomplicated and complicated patient groups. Receiver operating characteristic curve analysis was performed for parameters that differed between the two groups. Subgroup analysis was performed according to the substance ingested, thus acid or alkali.
Results: Thirty-seven patients were included in our study and eight had complications. Leukocyte, neutrophil counts, and the neutrophil-lymphocyte ratio of the complicated group were higher than those of the uncomplicated group. The areas under the receiver operating characteristic curves of leukocyte counts, neutrophil counts, and the neutrophil-lymphocyte ratio, were 0.819, 0.832, and 0.750, respectively. The cut-off values of these parameters for prediction of complications were 12 060/uL, 9607/uL, and 2.72, respectively. In subgroup analysis, the leukocyte and neutrophil counts, and the neutrophil-lymphocyte ratio of complicated patients who had ingested alkali were higher than those of the uncomplicated group.
Conclusion: Leukocyte counts, neutrophil counts, and the neutrophil-lymphocyte ratio might serve as useful predictors of complications after ingestion of caustic substances. |
Key words:
Blood cell count, Caustics, Esophagus, Wounds and injuries |
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