A retrospective study of use of polyvalent anti-snake venom and risk factors for mortality from snake bite in a tertiary care setting.
A retrospective study of use of polyvalent anti-snake venom and risk factors for mortality from snake bite in a tertiary care setting.
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DOI：
10.4103/0253-7613.157117
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发表时间：
2015-05
影响因子：
2.4
通讯作者：
Ghanghas RR
中科院分区：
文献类型：
--
作者：
Pore SM;Ramanand SJ;Patil PT;Gore AD;Pawar MP;Gaidhankar SL;Ghanghas RR
毒蛇中毒与相当高的发病率和死亡率有关。本研究旨在评估蛇咬伤患者抗蛇毒（ASV）的使用、ASV的早期不良反应、用药前治疗和临床结果。还评估了各种危险因素（年龄、性别、ASV剂量、蛇咬伤与ASV给药之间的时间间隔、机械通气的使用和蛇咬伤的类型）与死亡率的关系。本回顾性研究在两所三级教学医院进行。回顾性分析176例有使用ASV记录的蛇咬伤患者的医疗记录，检索相关资料。采用描述性统计表达ASV使用情况、ASV早期不良反应、用药前及临床结局。进行单因素和多因素分析，找出与死亡率相关的重要危险因素。ASV的主要适应证是血管毒性蛇咬伤（75%），其次是神经毒性蛇咬伤（16%）。ASV平均剂量为18.63±14.52瓶。超过70%的患者使用皮质类固醇单独或联合抗组胺药进行预防性预用药。4%的患者出现ASV的早期不良反应。在多变量分析中，神经毒性蛇咬伤是与死亡率相关的重要危险因素。神经毒性蛇咬伤是蛇咬伤患者死亡率的独立预测因子。目前使用的多价ASV可能在治疗神经毒性蛇咬伤方面效果较差。
Envenomation with poisonous snakes is associated with considerable morbidity and mortality. The present study was undertaken with the objectives of assessing anti-snake venom (ASV) use, early adverse reactions to ASV, premedication and clinical outcomes in snake bite patients. Association of various risk factors (age, gender, dose of ASV, time gap between snake bite and ASV administration, use of mechanical ventilation and type of snake bite) with mortality was also assessed. This retrospective study was conducted at two Tertiary Care Teaching Hospitals. The medical records of 176 patients of snake bite with documented use of ASV were retrospectively analyzed to retrieve relevant data. Descriptive statistics was used to express results about ASV use, early adverse reactions to ASV, premedication and clinical outcomes. Univariate and multivariate analysis was performed to find out significant risk factors associated with mortality. The main indication for ASV was vasculotoxic snake bite (75%) followed by neurotoxic snake bite (16%). Mean dose of ASV was 18.63 ± 14.52 vials. Prophylactic premedication with corticosteroids alone or in combination with antihistaminic was used in more than 70% patients. Early adverse reactions to ASV were seen in 4% patients. Neurotoxic snake bite was a significant risk factor associated with mortality in multivariate analysis. Neurotoxic snake bite is an independent predictor of mortality in snake bite patients. Currently used polyvalent ASV may be less effective in treating neurotoxic snake bite.
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影响因子：
2.8
作者：
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通讯作者：
Calvete, Juan J.
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