Evaluation of a Treatment Algorithm for Tsushima Mamushi (Gloydius tsushimaensis) Snakebites, after Its Introduction to Tsushima Island, Nagasaki, Japan
| Autor: | Takahiro Yasaka, Tomonori Kodama, Osamu Itose, Takeru Abe, Shogo Magome, Masayuki Tawara, Atsushi Sakai, Ichiro Takeuchi, Hideto Yokoi |
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| Rok vydání: | 2021 |
| Předmět: |
Gloydius tsushimaensis
retrospective study Gloydius Snake Bites snakebite Japan Interquartile range treatment strategy Internal Medicine Humans Medicine mamushi Retrospective Studies antivenom biology Antivenins business.industry Incidence (epidemiology) Significant difference Retrospective cohort study General Medicine Disseminated Intravascular Coagulation biology.organism_classification Treatment strategy Original Article business Algorithm Hospital stay Algorithms |
| Zdroj: | Internal Medicine |
| ISSN: | 1349-7235 0918-2918 |
| DOI: | 10.2169/internalmedicine.7131-21 |
| Popis: | Objective Tsushima mamushi (Gloydius tsushimaensis) is an endemic species of snake inhabiting only Tsushima Island, a remote Japanese island. We conducted a multicenter, retrospective study of G. tsushimaensis bites for the first time and developed a treatment algorithm that unified treatment on the island and is still in use today. Methods This is a multicenter, retrospective study comparing 72 cases from January 2005 to December 2018, before the introduction of the algorithm, and 12 cases from January 2019 to December 2020, after its introduction. Results There was no significant decrease in the maximum grade of symptoms after the introduction of the algorithm, but there was a decreasing trend (p=0.057). Conversely, the median of the maximum creatinine kinase levels was 343.5 IU/L (interquartile range: 115.5-4,745.5) before the algorithm's introduction and significantly lower (142.5; interquartile range: 111.3-163) after the algorithm's introduction (p=0.042). After the algorithm's introduction, the disseminated intravascular coagulation merger rate and the acute kidney injury incidence both dropped to 0%, from 9.7% and 6.9%, respectively, before the algorithm's introduction. There was no significant difference in the length of hospital stay before versus after the algorithm's introduction. Conclusion This study showed that the treatment algorithm can be safely and quickly applied. The algorithm's effectiveness is expected to be strengthened by the accumulation of more cases in the future. |
| Databáze: | OpenAIRE |
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