Epidemiological characteristics, hospital course and outcome of snakebite victims in West Texas

Abbey, James M; Jaffar, Nabil A; Abugrara, Hazem L; Nazim, Muhammad; Smalligan, Roger D.; Khasawneh, Faisal A

doi:10.1080/21548331.2015.1071637

Cited by 10 publications

(9 citation statements)

References 18 publications

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“…The concept has been described as bite Blegitimacy^ [16]. The predominance of upper extremity bites reported in numerous studies is consistent with intentional interactions with the snake [16][17][18][19]. Contrary to these historical reports, our results reflect a change in this pattern, and are more consistent with a recent study of snakebite reports in the media, which found 68% of bites to be legitimate encounters [20].…”

Section: Discussionsupporting

confidence: 89%

The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry

et al. 2017

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The American College of Medical Toxicology established the North American Snakebite Registry (NASBR), a national database of detailed, prospectively collected information regarding snake envenomation in the United States, in 2013. This report describes the epidemiology, clinical course, and management of snakebites in the NASBR. All cases entered into the NASBR between January 1, 2013 and December 31, 2015 were identified. Descriptive statistics are used to report results. Fourteen sites in 10 states entered 450 snakebites. Native species comprised 99% of cases, almost all of which were pit viper bites. 56.3% were identified as rattlesnakes and 29.4% as copperheads. 69.3% were male and 28.2% were children age 12 and under. Fifty-four percent of bites were on the lower extremity. Twenty-seven percent of patients with lower extremity bites were not wearing shoes. Common tissue findings associated with envenomation were swelling, ecchymosis, and erythema. Systemic effects and hematologic toxicity were more common in rattlesnake than copperhead or cottonmouth envenomations. Crotalidae Polyvalent Immune Fab antivenom was given to 84% of patients. Twelve patients (4.3%) were re-admitted to the hospital after completion of treatment. Eight were re-treated with antivenom. The NASBR gathers detailed data on venomous snakebites across the US. In its initial years, useful information has already been gained. Data regarding footwear will inform public health interventions and education, and information regarding the clinical presentation may help physicians better anticipate effects and manage snakebite. As the number of cases in the NASBR grows, associations between patient-related factors and outcomes may be studied.

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Section: Discussionsupporting

confidence: 89%

The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry

et al. 2017

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“…The clinical presentation is widely variable and may rapidly evolve in time. Symptoms depend on the involved species and the severity of envenomation [ 12 ]. We often distinguish the Cobraic syndrome responsible for neurotoxicity and the Viperic syndrome, more frequent, which is responsible for capillary leak syndrome and coagulation disorders.…”

Section: Discussionmentioning

confidence: 99%

Snakebite envenomation in children: An ongoing burden in Morocco

Essafti

Fajri

Rahmani

et al. 2022

Annals of Medicine &Amp; Surgery

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“…Male gender and a younger age are both risk factors for the development of opioid use disorder 32. These same patient characteristics are associated with increased risk of unintentional snake envenomation 33,34. Although males are at higher risk for opioid use disorder, the rate at which females overdose on prescription opioids is much higher 35.…”

Section: Discussionmentioning

confidence: 99%

Antivenom Treatment Is Associated with Fewer Patients using Opioids after Copperhead Envenomation

Freiermuth

Anderson

Kleinschmidt

et al. 2019

WestJEM

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Introduction Copperhead envenomation causes local tissue destruction, leading people to seek treatment for the pain and swelling. First-line treatment for the pain is opioid medications. There is rising concern that an initial opioid prescription from the emergency department (ED) can lead to long-term addiction. This analysis sought to determine whether use of Fab antivenom (FabAV) for copperhead envenomation affected opioid use. Methods We performed a secondary analysis using data from a randomized clinical trial designed to determine the effect of FabAV on limb injury recovery following mild to moderate copperhead envenomation. Opioid use was a defined secondary outcome in the parent trial. Patients were contacted after discharge, and data were obtained regarding medications used for pain and the patients’ functional status. This analysis describes the proportion of patients in each treatment group reporting opioid use at each time point. It also assesses the interaction between functional status and use of opioids. Results We enrolled 74 patients in the parent trial (45 received FabAV, 29 placebo), of whom 72 were included in this secondary analysis. Thirty-five reported use of any opioids after hospital discharge. A smaller proportion of patients treated with FabAV reported opioid use: 40.9% vs 60.7% of those in the placebo group. The proportion of patients using opioids remained smaller in the FabAV group at each follow-up time point. Controlling for confounders and interactions between variables, the model estimated that the odds ratio of using opioids after hospital discharge among those who received placebo was 5.67 times that of those who received FabAV. Patients who reported higher baseline pain, those with moderate as opposed to mild envenomation, and females were more likely to report opioid use at follow-up. Patients with ongoing limitations to functional status had an increased probability of opioid use, with a stronger association over time. Opioid use corresponded with the trial’s predefined criteria for full recovery, with only two patients reporting opioid use in the 24 hours prior to achieving full limb recovery and no patients in either group reporting opioid use after full limb recovery. Conclusion In this study population, the proportion of patients using opioids for pain related to envenomation was smaller in the FabAV treatment group at all follow-up time points.

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Epidemiological characteristics, hospital course and outcome of snakebite victims in West Texas

Abstract: Rattlesnake bites cause significant morbidity although mortality is rare. Early administration of antivenin and appropriate supportive measures and monitoring for complications with surgical intervention when needed leads to improved patient outcomes.

Cited by 10 publications

References 18 publications

The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry

The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry

Snakebite envenomation in children: An ongoing burden in Morocco

Antivenom Treatment Is Associated with Fewer Patients using Opioids after Copperhead Envenomation

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