Statistical analysis of anti-mamushi venom serum injection time and clinical course.

Abstract

Early injection of anti-mamushi venom serum (antiserum) is believed to be effective for the treatment of patients with mamushi bites. However, there is no firm information that indicates the time range constituting "early" injection. We tried to quantify the cut-off time of antiserum injection that brings favorable clinical courses by clarifying the relationship between the injection time and clinical outcome. We retrospectively analyzed the relationships between the time after bite, injection time of the antiserum, swelling grades, and laboratory values. The injection time of the antiserum in severe cases was significantly delayed as compared with non-severe cases. The best cut-off time of the antiserum injection that could distinguish non-severe and severe cases was 14h. In the group that received the antiserum within 14h, the antiserum injection may have successfully arrested the grade progression in a substantial number of cases. In the other group receiving the antiserum beyond 14h, the grades in many cases possibly may have peaked by the time of antiserum injection. The cut-off time of early injection for favorable clinical course was determined to be 14h. A statistical basis concerning the appropriate antiserum injection time was made to help prevent a severe clinical course due to delayed injection.