Journal of Acute Disease (Jan 2021)

Early severity predictors of snakebite envenomation in the southern region of Tunisia: a multivariate analysis

  • Olfa Chakroun-Walha,
  • Fadhila Issaoui,
  • Abdennour Nasri,
  • Haifa Bradai,
  • Ayman Farroukh,
  • Rim Karray,
  • Mouna Jerbi,
  • Noureddine Rekik

DOI
https://doi.org/10.4103/2221-6189.312155
Journal volume & issue
Vol. 10, no. 2
pp. 71 – 77

Abstract

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Objective: To identify the early predictors of severe envenomation in the southern region of Tunisia. Methods: It was a retrospective monocentric study including consecutive patients admitted to the emergency department for snakebite envenomation. Snakebite envenomation was defined by a history of snakebite. Predictors of severe envenomation were determined by univariate and multivariate analyses. Results: Our sample consisted of 109 patients aged 30 (20-44) years with a 1.1:1 sex-ratio (56 males and 53 females). During the 24-hour surveillance period, 25 patients developed severe envenomation (22.9%). The in-hospital mortality rate was 4.6% (n=5). The independent predictors of severe snakebite envenomation were leucocyte count over 11 550/mm3 (OR: 18.7, 95% CI: 3.3-107.8), creatine kinase over 155 IU/L (OR: 6.16, 95% CI: 1.1-35.6), and/or tourniquet before arrival to the ED (OR: 32.14, 95% CI: 3.5-295.9). Conclusions: This study emphasizes the importance of early evaluation of snakebite envenomation. Further studies are required to approve a severity scale proper to snakebite envenomation in Tunisia.

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