Diabetes is an independent risk factor for delayed perforation after foreign bodies impacted in esophagus in adults. Issue 8 (October 2018)

• Record Type: Journal Article
• Authors: Zhang, Shaowei; Wen, Jiaxin; Du, Mingmei; Liu, Yunxi; Zhang, Lianbin; Chu, Xiangyang; Xue, Zhiqiang
• Is Part Of: United European Gastroenterology journal. Volume 6:Issue 8(2018)
• Page Start: 1136
• Page End: 1143
• Publication Date: 2018-10
• Subjects: Esophageal perforation -- diabetes mellitus -- foreign bodies; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1177/2050640618784344
• Languages: English
• ISSNs: 2050-6406

Abstract

Background: Perforation is the most serious complication of esophageal foreign bodies. Studies examining the association between diabetes and esophageal foreign body-induced perforation are largely non-existent. Objectives: The purpose of this study was to identify the risk factors for esophageal foreign body-induced perforation. Methods: A retrospective chart review of patients with esophageal foreign bodies between January 2012–January 2017 was performed at the Chinese People's Liberation Army General Hospital. The patients were divided into two groups: those complicated with perforation and those without perforation. Date on patient demographics, symptoms, foreign bodies, and diabetes were collected and analyzed. Study-specific odds ratio and 95% confidence intervals (CI) were estimated using multivariable logistic regression models. Results: Of 294 patients with esophageal foreign bodies (41.84% male, mean age, 56.73 years), 33 (11.22%) complicated by perforation. Diabetes (odds ratio = 6.00; 95% confidence interval = 1.72–20.23), duration (>24 h) of foreign bodies retention (odds ratio = 4.25; 95% confidence interval = 1.71–10.86), and preoperative fever (odds ratio = 8.19; 95% confidence interval = 3.17–21.74) were strongly associated with an increased risk of perforation, whereas the sensation of a foreign body (odds ratio = 0.32; 95% confidence interval = 0.09–0.92) was a protective factor of perforation. Glucose level was not observed to have an association among patients with or without perforation. Conclusions: Diabetes and duration of foreign body retention increase risk for esophageal foreign bodies complicated by perforation, and cases with elevated armpit temperature may represented a more likely perforation compared with those without fever.