Assessing Physicians' Perspectives on Determinants of Endoscopy Decisions in Children Exposed to Non-Pharmacological Corrosive Agent: Insights from Poison Control Center - 02/09/25
: Dr, Nawaf Abdulrahman Alrakan c, d, Talal Abeid Alamri c, Yousef Hisham Alansari c, Osama Abeid Alamri c, Naif Salah Al Mulhem c, e, Abeer Jaber Mohamed f, Khalid A. Al-Mulhim g, Zahraa Khalifa Sobh hCet article a été publié dans un numéro de la revue, cliquez ici pour y accéder
Abstract |
Introduction: Endoscopy is the gold standard for assessing injuries after corrosive ingestion. Currently, there are no evidence-based protocols regulating the requirement for endoscopy. Thus, this study described clinicians' current practices in managing children exposed to corrosive agents by identifying the factors associated with requesting endoscopy and confirming which are typically associated with gastrointestinal damage.
Methods: A retrospective cross-sectional study analyzed 129 pediatric patients exposed to corrosive agents.
Results: Endoscopy was performed in 11.6% of cases. It was observed that 47.7% of those who underwent endoscopy showed positive findings. Children exposed to sulfuric acid and drain cleaners had higher chances of undergoing endoscopy. The initial presentation with drooling, dysphagia/pain, cough, shortness of breath, stridor, and redness and blisters around the mouth/lips was significantly associated with a higher likelihood of requesting an endoscopy (p<0.05). Patients who underwent endoscopy had significantly lower oxygen saturation (p<0.001), higher respiratory rates (p<0.001), and significantly lower pH, bicarbonate levels, and elevated glucose, electrolytes, bilirubin, creatinine, and leucocytic counts. Exposed patients who underwent endoscopy needed extended hospitalization (p<0.001). With odds ratios of 34.667, 28.0, and 25.778, drooling, dysphagia/pain, and abnormal findings in chest X-ray were the best predictors of positive findings in endoscopy, respectively.
Conclusion: While we highlight some factors prioritizing the decision of endoscopy by clinicians, this study points to the significant role of drooling, dysphagia/pain, and abnormal findings in chest X-ray in supporting this decision. Clinical triage tools based on these predictors may help allocate care efficiently in low-resource settings.
Le texte complet de cet article est disponible en PDF.Keywords : Corrosive ingestion, Decision, Endoscopy, Corrosive injuries, Acids, Alkalis
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