Chakroun-Walha Olfa, Karray Rim, Jerbi Mouna, Nasri Abdennour, Issaoui Fadhila, Amine Ben Rebeh, Bahloul Mabrouk, Bouaziz Mounir, Ksibi Hichem, Rekik Noureddine
Emergency Department, Habib Bourguiba University Hospital, Sfax, Tunisia (Drs Chakroun-Walha, Karray, Jerbi, Nasri, Issaoui, Rebeh, Ksibi, and Rekik).
Emergency Department, Habib Bourguiba University Hospital, Sfax, Tunisia (Drs Chakroun-Walha, Karray, Jerbi, Nasri, Issaoui, Rebeh, Ksibi, and Rekik).
Wilderness Environ Med. 2018 Mar;29(1):29-35. doi: 10.1016/j.wem.2017.09.011. Epub 2018 Jan 12.
Scorpion envenomation is still a frequent occurance in tropical and subtropical regions. In Tunisia, multiple studies on scorpion envenoming have contributed to an improved understanding of cardiac dysfunction and factors predictive of poor prognosis. These previous studies have contributed to the current standardized management of envenomed patients. However, the epidemiology of scorpion envenoming in Tunisia has not been updated for more than 10 years. The aim of this study was to report an update of the epidemiological features of scorpion envenomation in the southern region of Tunisia.
This is a retrospective monocentric study including all patients admitted in the emergency room for scorpion envenomation. Cases were collected from emergency medical files during a 3-year period (2013-2015). The diagnosis of scorpion envenomation was made by history of a scorpion sting. All files in which scorpion envenomation was not certain were excluded. Data are presented as mean±SD with range or percentages, as appropriate.
We enrolled 282 patients aged 27.4±22.8 years with a 1:1 sex ratio. During surveillance in the emergency room, 39 patients developed cardiac dysfunction. Overall, 42 patients (14.9%) were at stage 3 of severity, and 240 patients (85.1%) had moderate scorpion envenomation (stage 2). Only 1 patient died a few hours after admission. In the remaining cases, the outcome was good. Our results show the improvement in mortality rates even in severe presentations.
This study found that the outcome of scorpion-stung patients has clearly improved. This enhancement can be explained by early medical consultation and standardized management of patients with predictive factors for cardiac dysfunction.
蝎子蜇伤在热带和亚热带地区仍然频繁发生。在突尼斯，多项关于蝎子蜇伤的研究有助于更好地理解心脏功能障碍以及预测预后不良的因素。这些先前的研究为目前对蜇伤患者的标准化管理做出了贡献。然而，突尼斯蝎子蜇伤的流行病学已有十多年未更新。本研究的目的是报告突尼斯南部地区蝎子蜇伤流行病学特征的最新情况。
这是一项回顾性单中心研究，纳入了所有因蝎子蜇伤而入住急诊室的患者。病例收集自3年期间（2013 - 2015年）的急诊医疗档案。蝎子蜇伤的诊断依据蝎子蜇伤史。所有蝎子蜇伤情况不确定的档案均被排除。数据以均值±标准差表示，并根据情况给出范围或百分比。
我们纳入了282例年龄为27.4±22.8岁的患者，男女比例为1:1。在急诊室监测期间，39例患者出现心脏功能障碍。总体而言，42例患者（14.9%）处于重度3期，240例患者（85.1%）为中度蝎子蜇伤（2期）。仅1例患者在入院后数小时死亡。其余病例预后良好。我们的结果表明，即使在严重病例中死亡率也有所改善。
本研究发现蝎子蜇伤患者的预后有明显改善。这种改善可归因于早期就医以及对有心脏功能障碍预测因素的患者进行标准化管理。
