关于水腹蛇（食鱼蝮）咬伤报告严重程度的流行病学。

Epidemiology of the reported severity of cottonmouth (Agkistrodon piscivorus) snakebite.

作者信息

Walter Frank G, Stolz Uwe, French Robert N E, Chase Peter B, McNally Jude, Shirazi Farshad

机构信息

From the Department of Emergency Medicine, Section of Medical Toxicology, College of Medicine, the Arizona Emergency Medicine Research Center, College of Medicine, University of Arizona, and Rare Disease Therapeutics, Tucson.

出版信息

South Med J. 2014 Mar;107(3):150-6. doi: 10.1097/SMJ.0000000000000067.

DOI:10.1097/SMJ.0000000000000067

PMID:24937331

Abstract

OBJECTIVE

The goal of this study was to analyze trends in the annual rates of reported medical outcomes of cottonmouth (Agkistrodon piscivorus) snakebites in the United States, published in the annual reports of the American Association of Poison Control Centers in the course of 29 years.

METHODS

This was a retrospective analysis of medical outcomes for cottonmouth snakebite victims who developed fatal, major, moderate, minor, or no effects. The annual rates for these medical outcomes were calculated by dividing the annual number of patients in each outcome category by the total annual number of people reported as being bitten by cottonmouths. Negative binomial regression was used to examine trends in annual rates.

RESULTS

From 1985 through 2011, after controlling for the availability of CroFab, the annual incidence rate of cottonmouth snakebites causing no effect decreased significantly by 7.3%/year (incidence rate ratio [IRR] 0.927, 95% confidence interval [CI] 0.885-0.970), the incidence rate of minor outcomes did not change significantly (IRR 0.989, CI 0.974-1.006), the incidence rate of moderate outcomes increased significantly by 2.3%/year (IRR 1.023, CI 1.004-1.042), and the incidence rate of major outcomes did not change significantly (IRR 0.987, CI 0.935-1.041). One fatality was reported in 2011.

CONCLUSIONS

Annual rates of cottonmouth snakebites producing no effects decreased significantly, those producing minor outcomes did not change significantly, those producing moderate outcomes increased significantly, and those producing major outcomes did not change significantly, from 1985 through 2011.

摘要

目的

本研究旨在分析美国毒物控制中心协会29年年度报告中公布的美国水腹蛇（食鱼蝮）咬伤报告的年度医疗结果趋势。

方法

这是一项对水腹蛇咬伤受害者的医疗结果进行的回顾性分析，这些受害者出现了致命、严重、中度、轻度或无影响的情况。这些医疗结果的年发生率通过将每个结果类别中的年患者数除以报告被水腹蛇咬伤的总年人数来计算。使用负二项回归来检查年发生率的趋势。

结果

从1985年到2011年，在控制了抗蛇毒血清（CroFab）的可获得性后，水腹蛇咬伤无影响的年发病率显著下降，每年下降7.3%（发病率比[IRR]0.927，95%置信区间[CI]0.885 - 0.970），轻度结果的发病率没有显著变化（IRR 0.989，CI 0.974 - 1.006），中度结果的发病率显著上升，每年上升2.3%（IRR 1.023，CI 1.004 - 1.042），严重结果的发病率没有显著变化（IRR 0.987，CI 0.935 - 1.041）。2011年报告了1例死亡病例。