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독사 교상 환자의 응급실 초기 검사에 따른 예후 예측 인자

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Author(s)
백인엽김태균진상찬최우익
Keimyung Author(s)
Jin, Sang ChanChoi, Woo Ik
Department
Dept. of Emergency Medicine (응급의학)
Journal Title
대한임상독성학회지
Issued Date
2017
Volume
15
Issue
1
Keyword
Snake bitesSnake venomPrognostic predictors
Abstract
Purpose: This study was conducted to identify predictors of serious poisoning in patients with snake bite based on initial findings. Methods: We conducted a retrospective study of patients with snake bite who were treated at the emergency department between January 2010 and December 2016. The patients were divided into two groups according to the severity of symptoms based on the traditional snakebite severity grading scale. The mild poisoning group (MP) was classified as those who had a grade I snakebite severity during the hospital stay, and the severe poisoning group (SP) was classified as patients who had grade I at the time of admission, but progressed to grade II-IV during hospitalization. Initial clinical manifestations and laboratory findings of the two groups were compared. Results: Bite to hospital time intervals of SP were longer than those of MP (p=0.034), and the local effect score (LES) was higher in SP (p<0.001). Laboratory analyses revealed that creatine phosphokinase (p=0.044), creatine phosphokinase MB isoenzyme (CK-MB, p=0.011) and serum amylase (p=0.008) were significantly higher in SP. LES, CK-MB and serum amylase were significant prognostic predictors as indicated by univariate logistic regression analysis. Multivariate analysis revealed the following two significant predictors: LES (odds ratio=3.983, p<0.001) and serum amylase (odds ratio=1.020, p=0.017). Conclusion: In managing cases of snake bites, clinical manifestations and laboratory findings must be carefully evaluated. LES and serum amylase are predictive factors for severe poisoning, which is especially important to rapid determination of the intensive care of the patient.
Alternative Title
Prognostic Predictors of Outcome in Patients with Snake Bite, Based on Initial Findings in the Emergency Department
Keimyung Author(s)(Kor)
진상찬
최우익
Publisher
School of Medicine
Citation
백인엽 et al. (2017). 독사 교상 환자의 응급실 초기 검사에 따른 예후 예측 인자. 대한임상독성학회지, 15(1), 1–10. doi: 10.22537/jksct.15.1.1
Type
Article
ISSN
1738-1320
DOI
10.22537/jksct.15.1.1
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32631
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학)
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