Predictors of the development of post-snakebite compartment syndrome

• Published in: Scandinavian journal of trauma, resuscitation and emergency medicine resuscitation and emergency medicine, 2015-11, Vol.23 (96), p.97-97, Article 97
• Main Authors: Hsu, Chih-Po, Chuang, Jung-Fang, Hsu, Yu-Pao, Wang, Shang-Yu, Fu, Chih-Yuan, Yuan, Kuo-Ching, Chen, Chih-Hao, Kang, Shih-Ching, Liao, Chien-Hung
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analysis; Antivenins - administration & dosage; Aspartate aminotransferase; Bites and stings; Blood cell count; Blood pressure; Care and treatment; Cohort Studies; Compartment syndrome; Compartment Syndromes - epidemiology; Compartment Syndromes - etiology; Compartment Syndromes - physiopathology; Compartment Syndromes - surgery; Demographics; Emergency medical care; Fasciotomy; Female; Follow-Up Studies; Hospitalization; Humans; Incidence; Laboratories; Length of stay; Male; Middle Aged; Monitoring, Physiologic - methods; Multivariate Analysis; Original Research; Patients; Predictive Value of Tests; Retrospective Studies; Risk Assessment; Risk factors; Severity of Illness Index; Snake bites; Snake Bites - diagnosis; Snake Bites - epidemiology; Snake Bites - therapy; Snake Venoms - blood; Snakes; Taiwan; Trauma; Trauma centers; Treatment Outcome; Venom
• ISSN: 1757-7241; 1757-7241
• DOI: 10.1186/s13049-015-0179-y

To identify the factors associated with the development of post-snakebite compartment syndrome (PSCS) in snakebite patients and to analyze the clinical prognosis of these patients. We retrospectively reviewed the medical records of patients who presented to our institution with snakebites from March 2009 to December 2012. The clinical data, hospital course and outcome were all recorded. A total of 136 patients were included in the present study. Nine patients developed PSCS and underwent fasciotomy. Relative to the non-PSCS group, the PSCS group demonstrated a significant increase in the white blood cell count (WBC, p = 0.006), segment form (Seg, p ≤ 0.001), aspartate aminotransferase level (AST, p = 0.002) and alanine aminotransferase level (ALT, p = 0.008). Elevated WBC count and AST level were identified as independent risk factors for PSCS (p = 0.028 and 0.037, respectively) in a multivariate analysis. Snakebite patients have a high likelihood of developing locoregional complications such as PSCS. Symptomatic snakebite patients should be observed for at least 48 h, and increased WBC counts and AST levels are risk factors for PSCS.