Abstract
BackgroundTo identify the factors associated with the development of post-snakebite compartment syndrome (PSCS) in snakebite patients and to analyze the clinical prognosis of these patients.MethodsWe retrospectively reviewed the medical records of patients who presented to our institution with snakebites from March 2009 to December 2012. The clinical data, hospital course and outcome were all recorded.ResultsA total of 136 patients were included in the present study. Nine patients developed PSCS and underwent fasciotomy. Relative to the non-PSCS group, the PSCS group demonstrated a significant increase in the white blood cell count (WBC, p = 0.006), segment form (Seg, p ≤ 0.001), aspartate aminotransferase level (AST, p = 0.002) and alanine aminotransferase level (ALT, p = 0.008). Elevated WBC count and AST level were identified as independent risk factors for PSCS (p = 0.028 and 0.037, respectively) in a multivariate analysis.ConclusionsSnakebite patients have a high likelihood of developing locoregional complications such as PSCS. Symptomatic snakebite patients should be observed for at least 48 h, and increased WBC counts and AST levels are risk factors for PSCS.
Highlights
Snakebites remain a public health problem worldwide
There have been limited reports concerning post-snakebite compartment syndrome (PSCS) [2, 3], and there is a lack of consensus regarding the diagnosis and management of PSCS
We identified factors associated with the development of PSCS in snakebite patients and analyzed the prognosis of these patients
Summary
The clinical presentations of snakebites vary from symptomless to life threatening [1]. Snakebites require vigilance regarding both the systemic effects of the venom and the locoregional impact on the soft tissues. The widespread use of antivenom has allowed the systemic effect of venom to be controlled with an acceptable prognosis. Severe tissue necrosis induces the development of compartment syndrome, which is a rare but lethal complication after a snakebite. There have been limited reports concerning post-snakebite compartment syndrome (PSCS) [2, 3], and there is a lack of consensus regarding the diagnosis and management of PSCS. To identify the factors associated with the development of post-snakebite compartment syndrome (PSCS) in snakebite patients and to analyze the clinical prognosis of these patients
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