Liang Xun, Xing Danlei, Zhuang Zhiwei, Feng Hui, Li Shiji, Fang Xiao, Wang Fei, Qiu Le, Chen Xu-Lin
Department of Emergency Surgery, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, 230032, People's Republic of China.
Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People's Republic of China.
J Inflamm Res. 2025 Apr 18;18:5281-5291. doi: 10.2147/JIR.S507234. eCollection 2025.
Snakebite-induced organ dysfunction emerging as the primary determinant of morbidity and mortality. This study aims to explore the prognostic value of red blood cell distribution width (RDW) to platelet ratio (RPR) on multi-organ dysfunction (MODS) in patients with snake bites.
A retrospective study included 637 patients with snakebite between 2015 and 2020 from two hospitals in Anhui province, China. Data were collected at two time points: on the 1-day and the 5-day after treatment. All patients were divided into two groups according to the presence or absence of MODS. -tests, chi-square tests, and univariate and multivariate logistical analyses were used to identify the prognostic factors for the development of MODS.
56 (8.8%) patients developed MODS following snakebite. Logistics analyses indicated that from being bitten at the hospital, the 1-day of red blood cell distribution width-to-platelet ratio (RPR) and creatinine (CR) levels, and the 5-day of aspartate aminotransferase (AST) were significantly associated with the development of MODS. The sensitivity and the specificity of the 1-day RPR were calculated by the received operating characteristic curve (AUC=0.720, 95% CI, 0.642-0.798). The 1 day RPR=0.110 and the 5 day RPR=0.085.
The study found that the RPR is an independent risk factor for predicting multi-organ dysfunction in patients with snake bites. The 1-day RPR >0.110 is prone to be a new independent predictive factor for the development of MODS after snakebite.
蛇咬伤所致器官功能障碍已成为发病率和死亡率的主要决定因素。本研究旨在探讨红细胞分布宽度（RDW）与血小板比值（RPR）对蛇咬伤患者多器官功能障碍（MODS）的预后价值。
一项回顾性研究纳入了2015年至2020年间来自中国安徽省两家医院的637例蛇咬伤患者。在两个时间点收集数据：治疗后第1天和第5天。所有患者根据是否发生MODS分为两组。采用t检验、卡方检验以及单因素和多因素逻辑分析来确定MODS发生的预后因素。
56例（8.8%）患者蛇咬伤后发生MODS。逻辑分析表明，从在医院被咬起，第1天的红细胞分布宽度与血小板比值（RPR）和肌酐（CR）水平，以及第5天的天冬氨酸转氨酶（AST）与MODS的发生显著相关。通过接受者操作特征曲线计算第1天RPR的敏感性和特异性（AUC = 0.720，95%CI，0.642 - 0.798）。第1天RPR = 0.110，第5天RPR = 0.085。
该研究发现RPR是预测蛇咬伤患者多器官功能障碍的独立危险因素。第1天RPR>0.110易于成为蛇咬伤后MODS发生的新的独立预测因素。
