Walter Frank G, Stolz Uwe, Shirazi Farshad, McNally Jude
Section of Medical Toxicology, Department of Emergency Medicine, College of Medicine, University of Arizona, Tucson, AZ 85724-5057, USA.
Clin Toxicol (Phila). 2009 Aug;47(7):663-9. doi: 10.1080/15563650903113701.
No study has focused on the nationwide epidemiology of severe and fatal rattlesnake bites during the last 25 years. We examined rates and temporal trends of severe and fatal rattlesnake bites across the United States. Our hypothesis was that nationwide annual rates of both severe and fatal outcomes from rattlesnake bites have remained unchanged over time.
This study retrospectively analyzed all human rattlesnake bites published in the Annual Reports of the American Association of Poison Control Centers from 1983 through 2007. Annual rates of severe (major) and fatal rattlesnake bites were calculated using the annual number of major outcomes and fatalities as respective numerators and the total annual number of single rattlesnake bites (exposures) as denominators. Negative binomial and Poisson regressions were used to examine trends of severe and fatal rattlesnake bites over time.
Annually, from 1985 to 2007, the incidence rate of major outcomes decreased by 2% per year (incidence rate ratio = 0.980; CI = 0.967-0.993), corresponding to an absolute annual rate decrease of two major outcomes per 1,000 bites per year. Annual rates of fatalities showed no statistically significant change from 1983 through 2007.
This is the first study to examine rates and trends of published severe and fatal rattlesnake bites across the United States over the past 25 years. Annual rates of severe rattlesnake bites, derived from the published Annual Reports of the American Association of Poison Control Centers, have significantly decreased over time, whereas rates of fatal rattlesnake bites have remained unchanged.
在过去25年中，尚无研究关注响尾蛇咬伤导致重伤和死亡的全国性流行病学情况。我们调查了美国严重和致命响尾蛇咬伤的发生率及时间趋势。我们的假设是，随着时间推移，全国范围内响尾蛇咬伤导致重伤和死亡的年发生率保持不变。
本研究回顾性分析了1983年至2007年美国毒物控制中心协会年度报告中公布的所有人类响尾蛇咬伤病例。严重（主要）和致命响尾蛇咬伤的年发生率分别以主要后果和死亡的年度数量为分子，以单例响尾蛇咬伤（暴露）的年度总数为分母进行计算。使用负二项式和泊松回归分析严重和致命响尾蛇咬伤随时间的趋势。
1985年至2007年期间，主要后果的发生率每年下降2%（发生率比=0.980；置信区间=0.967-0.993），相当于每年每1000次咬伤中主要后果的绝对年发生率下降2例。1983年至2007年期间，死亡率的年发生率无统计学显著变化。
这是第一项研究过去25年美国已公布的严重和致命响尾蛇咬伤发生率及趋势的研究。根据美国毒物控制中心协会已公布的年度报告得出的严重响尾蛇咬伤年发生率随时间显著下降，而致命响尾蛇咬伤发生率保持不变。
