RESUMO
AIM: Acute kidney injury (AKI) is one of the main causes of morbidity and mortality in cases of envenomation by venomous snakes. The present study was carried out to investigate the clinical and laboratory manifestations in accidents with venomous snakes and the risk factors associated with AKI in these accidents. METHODS: A retrospective study was carried out with patients victims of snakebite admitted to a reference centre. AKI was defined according to the RIFLE and AKIN criteria. RESULTS: A total of 276 patients were included, of which 230 (83.7%) were males. AKI was observed in 42 cases (15.2%). The mean genus involved in the accidents was Bothrops (82.2%). Mean age of patients with AKI was higher than in patients without AKI (43 ± 20 vs. 34 ± 21 years, P = 0.015). The time elapsed between the accident and medical care was higher in the AKI group (25 ± 28 vs. 14 ± 16h, P = 0.034), as well as the time elapsed between the accident and the administration of antivenom (30.7 ± 27 vs. 15 ± 16 h, P = 0.01). Haemodialysis was required in 30% of cases and complete renal function recovery was observed in 54.8% of cases at hospital discharge. There were four deaths, none of which had AKI. Factors associated with AKI were haemorrhagic abnormalities (P = 0.036, OR = 6.718, 95% CI: 1.067-25.661) and longer length of hospital stay (P = 0.004, OR = 1.69, 95% CI 1.165-2.088). CONCLUSION: Acute kidney injury is an important complication of snakebite accidents, showing low mortality, but high morbidity, which can lead to partial renal function recovery.
Assuntos
Injúria Renal Aguda/etiologia , Antivenenos/uso terapêutico , Mordeduras de Serpentes/terapia , Venenos de Serpentes , Centros de Atenção Terciária , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/fisiopatologia , Injúria Renal Aguda/terapia , Adolescente , Adulto , Brasil , Distribuição de Qui-Quadrado , Feminino , Humanos , Rim/fisiopatologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Recuperação de Função Fisiológica , Diálise Renal , Estudos Retrospectivos , Fatores de Risco , Mordeduras de Serpentes/complicações , Mordeduras de Serpentes/mortalidade , Fatores de Tempo , Tempo para o Tratamento , Resultado do Tratamento , Adulto JovemRESUMO
The aim of this study was to describe the epidemiological profile of snakebite accidents reported by the toxicological assistance center in Fortaleza, Ceará, Brazil. Database information on snakebite accidents was analyzed regarding the period from January 2003 to December 2011. A total of 1063 cases were found. The accidents occurred during the rainy months (March, April and May), in urban areas (52.3%), affecting individuals younger than 50 years and predominantly among males (70.7%). The lower limbs were the most frequently affected body area (33.7%). Most accidents involved non-venomous snakes (76.1%). The genus Bothrops was the main one involved in venomous accidents (83%). It is expected that this study can be used as the substrate to improve healthcare surveillance and implementing better measures for the treatment of this population.
Assuntos
Mordeduras de Serpentes/epidemiologia , Adolescente , Adulto , Idoso , Animais , Bothrops , Brasil/epidemiologia , Criança , Pré-Escolar , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , População Rural , Índice de Gravidade de Doença , População Urbana , Adulto JovemRESUMO
SUMMARY The aim of this study was to describe the epidemiological profile of snakebite accidents reported by the toxicological assistance center in Fortaleza, Ceará, Brazil. Database information on snakebite accidents was analyzed regarding the period from January 2003 to December 2011. A total of 1063 cases were found. The accidents occurred during the rainy months (March, April and May), in urban areas (52.3%), affecting individuals younger than 50 years and predominantly among males (70.7%). The lower limbs were the most frequently affected body area (33.7%). Most accidents involved non-venomous snakes (76.1%). The genus Bothrops was the main one involved in venomous accidents (83%). It is expected that this study can be used as the substrate to improve healthcare surveillance and implementing better measures for the treatment of this population. .
RESUMO O objetivo deste estudo é descrever o perfil epidemiológico dos acidentes ofídicos atendidos e notificados ao Centro de Assistência Toxicológica (CEATOX), em Fortaleza, Ceará, Brasil. Foram analisadas informações sobre os acidentes ofídicos relativos ao período compreendido entre janeiro de 2003 a dezembro de 2011, por meio de banco de dados. Os resultados demonstraram 1063 casos notificados ao CEATOX, Ceará. Os acidentes ocorreram principalmente em meses chuvosos (março, abril e maio), em áreas urbanas (52,3%), em uma faixa etária menor de 50 anos, acometendo predominantemente o sexo masculino (70,7%). Os membros inferiores foram os locais mais afetados (33,7%). A maior parte dos acidentes envolveu serpentes não peçonhentas (76,1%). O gênero Bothrops foi o maior responsável pelos acidentes com serpentes peçonhentas (83%). Espera-se que os dados da casuística obtida sirvam de ferramenta para o planejamento de medidas de saúde voltadas para prevenção e atendimento mais adequado da população em estudo. .
