Time to treatment and severity of snake envenoming in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFBA |
Texto Completo: | http://repositorio.ufba.br/ri/handle/ri/29678 |
Resumo: | Objective. To analyze the relationship between time to treatment and severity of snakebite envenomation in Brazil. Methods. This case-series retrospective study analyzed 144 251 snakebite cases in Brazil between 2007 and 2015, as reported to the Brazilian Notifiable Diseases Information System. The main dependent variable was snakebite envenomation severity (mild/moderate/severe). The main predictor was time to treatment (early (< 6 hours) vs. delayed (ë 6 hours)). Covariables were snake type(Bothrops/Crotalus/Micrurus/Lachesis), patient’s age and sex, bite site, and treatment at a specialized care center (center/noncenter). Polytomous logistic regression techniques were used to control the covariates and assess confounding and effect modification. Results. The time to treatment variable was strongly associated with the severity of snakebite envenomation. Snake type and treatment at specialized care center modified the main association effect. The association between delayed time to treatment and envenomation severity was consistently stronger among patients treated at specialized care centers than among those who were not treated at such centers. Odds ratios tended to increase significantly from moderate to severe envenomation for cases within the subgroups “Center + Bothrops” (1.37 to 2.05),“No center + Bothrops” (1.25 to 1.47), “Center + Crotalus” (1.35 to 3.03), “No center + Crotalus” (0.97 to 2.72), and “Center + Lachesis” (1.22 to 1.89). Discussion. This study confirmed the classical hypothesis that the time between snakebite and initiation of medical care is associated with severity of snakebite envenomation. It is therefore necessary to provide snakebite victims early access to specialized medical care, particularly to antivenom therapy. |
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Mise, Yukari FigueroaLira-da-Silva, Rejâne MariaCarvalho, Fernando MartinsMise, Yukari FigueroaLira-da-Silva, Rejâne MariaCarvalho, Fernando Martins2019-05-27T17:44:46Z2019-05-27T17:44:46Z2018http://repositorio.ufba.br/ri/handle/ri/29678Rev. Panam. Salud Publica, v. 42, p.1-6, 2018.Objective. To analyze the relationship between time to treatment and severity of snakebite envenomation in Brazil. Methods. This case-series retrospective study analyzed 144 251 snakebite cases in Brazil between 2007 and 2015, as reported to the Brazilian Notifiable Diseases Information System. The main dependent variable was snakebite envenomation severity (mild/moderate/severe). The main predictor was time to treatment (early (< 6 hours) vs. delayed (ë 6 hours)). Covariables were snake type(Bothrops/Crotalus/Micrurus/Lachesis), patient’s age and sex, bite site, and treatment at a specialized care center (center/noncenter). Polytomous logistic regression techniques were used to control the covariates and assess confounding and effect modification. Results. The time to treatment variable was strongly associated with the severity of snakebite envenomation. Snake type and treatment at specialized care center modified the main association effect. The association between delayed time to treatment and envenomation severity was consistently stronger among patients treated at specialized care centers than among those who were not treated at such centers. Odds ratios tended to increase significantly from moderate to severe envenomation for cases within the subgroups “Center + Bothrops” (1.37 to 2.05),“No center + Bothrops” (1.25 to 1.47), “Center + Crotalus” (1.35 to 3.03), “No center + Crotalus” (0.97 to 2.72), and “Center + Lachesis” (1.22 to 1.89). Discussion. This study confirmed the classical hypothesis that the time between snakebite and initiation of medical care is associated with severity of snakebite envenomation. It is therefore necessary to provide snakebite victims early access to specialized medical care, particularly to antivenom therapy.Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2019-05-20T19:20:45Z No. of bitstreams: 1 ARTIGO Yukari Figueroa. 2018.pdf: 1601683 bytes, checksum: 0b1ccd0a7203a34f224cc48f49a9e6f7 (MD5)Approved for entry into archive by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2019-05-27T17:44:46Z (GMT) No. of bitstreams: 1 ARTIGO Yukari Figueroa. 2018.pdf: 1601683 bytes, checksum: 0b1ccd0a7203a34f224cc48f49a9e6f7 (MD5)Made available in DSpace on 2019-05-27T17:44:46Z (GMT). No. of bitstreams: 1 ARTIGO Yukari Figueroa. 2018.pdf: 1601683 bytes, checksum: 0b1ccd0a7203a34f224cc48f49a9e6f7 (MD5)Washington - D.Chttps://scielosp.org/pdf/rpsp/2018.v42/e52/enreponame:Repositório Institucional da UFBAinstname:Universidade Federal da Bahia (UFBA)instacron:UFBASnake bitesPatient acuityTime to treatmentBrazilTime to treatment and severity of snake envenoming in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleBrasilinfo:eu-repo/semantics/openAccessengORIGINALARTIGO Yukari Figueroa. 2018.pdfARTIGO Yukari Figueroa. 2018.pdfapplication/pdf1601683https://repositorio.ufba.br/bitstream/ri/29678/1/ARTIGO%20Yukari%20Figueroa.%202018.pdf0b1ccd0a7203a34f224cc48f49a9e6f7MD51LICENSElicense.txtlicense.txttext/plain1383https://repositorio.ufba.br/bitstream/ri/29678/2/license.txt690bb9e0ab0d79c4ae420a800ae539f0MD52TEXTARTIGO Yukari Figueroa. 2018.pdf.txtARTIGO Yukari Figueroa. 2018.pdf.txtExtracted texttext/plain32483https://repositorio.ufba.br/bitstream/ri/29678/3/ARTIGO%20Yukari%20Figueroa.%202018.pdf.txtb8f3e438d4807612a3cc1958d1384a5cMD53ri/296782022-10-22 18:32:58.563oai:repositorio.ufba.br:ri/29678VGVybW8gZGUgTGljZW4/P2EsIG4/P28gZXhjbHVzaXZvLCBwYXJhIG8gZGVwPz9zaXRvIG5vIFJlcG9zaXQ/P3JpbyBJbnN0aXR1Y2lvbmFsIGRhIFVGQkEuCgogUGVsbyBwcm9jZXNzbyBkZSBzdWJtaXNzPz9vIGRlIGRvY3VtZW50b3MsIG8gYXV0b3Igb3Ugc2V1IHJlcHJlc2VudGFudGUgbGVnYWwsIGFvIGFjZWl0YXIgCmVzc2UgdGVybW8gZGUgbGljZW4/P2EsIGNvbmNlZGUgYW8gUmVwb3NpdD8/cmlvIEluc3RpdHVjaW9uYWwgZGEgVW5pdmVyc2lkYWRlIEZlZGVyYWwgZGEgQmFoaWEgCm8gZGlyZWl0byBkZSBtYW50ZXIgdW1hIGM/P3BpYSBlbSBzZXUgcmVwb3NpdD8/cmlvIGNvbSBhIGZpbmFsaWRhZGUsIHByaW1laXJhLCBkZSBwcmVzZXJ2YT8/Pz9vLiAKRXNzZXMgdGVybW9zLCBuPz9vIGV4Y2x1c2l2b3MsIG1hbnQ/P20gb3MgZGlyZWl0b3MgZGUgYXV0b3IvY29weXJpZ2h0LCBtYXMgZW50ZW5kZSBvIGRvY3VtZW50byAKY29tbyBwYXJ0ZSBkbyBhY2Vydm8gaW50ZWxlY3R1YWwgZGVzc2EgVW5pdmVyc2lkYWRlLgoKIFBhcmEgb3MgZG9jdW1lbnRvcyBwdWJsaWNhZG9zIGNvbSByZXBhc3NlIGRlIGRpcmVpdG9zIGRlIGRpc3RyaWJ1aT8/Pz9vLCBlc3NlIHRlcm1vIGRlIGxpY2VuPz9hIAplbnRlbmRlIHF1ZToKCiBNYW50ZW5kbyBvcyBkaXJlaXRvcyBhdXRvcmFpcywgcmVwYXNzYWRvcyBhIHRlcmNlaXJvcywgZW0gY2FzbyBkZSBwdWJsaWNhPz8/P2VzLCBvIHJlcG9zaXQ/P3Jpbwpwb2RlIHJlc3RyaW5naXIgbyBhY2Vzc28gYW8gdGV4dG8gaW50ZWdyYWwsIG1hcyBsaWJlcmEgYXMgaW5mb3JtYT8/Pz9lcyBzb2JyZSBvIGRvY3VtZW50bwooTWV0YWRhZG9zIGVzY3JpdGl2b3MpLgoKIERlc3RhIGZvcm1hLCBhdGVuZGVuZG8gYW9zIGFuc2Vpb3MgZGVzc2EgdW5pdmVyc2lkYWRlIGVtIG1hbnRlciBzdWEgcHJvZHU/Pz8/byBjaWVudD8/ZmljYSBjb20gCmFzIHJlc3RyaT8/Pz9lcyBpbXBvc3RhcyBwZWxvcyBlZGl0b3JlcyBkZSBwZXJpPz9kaWNvcy4KCiBQYXJhIGFzIHB1YmxpY2E/Pz8/ZXMgc2VtIGluaWNpYXRpdmFzIHF1ZSBzZWd1ZW0gYSBwb2w/P3RpY2EgZGUgQWNlc3NvIEFiZXJ0bywgb3MgZGVwPz9zaXRvcyAKY29tcHVscz8/cmlvcyBuZXNzZSByZXBvc2l0Pz9yaW8gbWFudD8/bSBvcyBkaXJlaXRvcyBhdXRvcmFpcywgbWFzIG1hbnQ/P20gYWNlc3NvIGlycmVzdHJpdG8gCmFvIG1ldGFkYWRvcyBlIHRleHRvIGNvbXBsZXRvLiBBc3NpbSwgYSBhY2VpdGE/Pz8/byBkZXNzZSB0ZXJtbyBuPz9vIG5lY2Vzc2l0YSBkZSBjb25zZW50aW1lbnRvCiBwb3IgcGFydGUgZGUgYXV0b3Jlcy9kZXRlbnRvcmVzIGRvcyBkaXJlaXRvcywgcG9yIGVzdGFyZW0gZW0gaW5pY2lhdGl2YXMgZGUgYWNlc3NvIGFiZXJ0by4KRepositório InstitucionalPUBhttp://192.188.11.11:8080/oai/requestopendoar:19322022-10-22T21:32:58Repositório Institucional da UFBA - Universidade Federal da Bahia (UFBA)false |
dc.title.pt_BR.fl_str_mv |
Time to treatment and severity of snake envenoming in Brazil |
title |
Time to treatment and severity of snake envenoming in Brazil |
spellingShingle |
Time to treatment and severity of snake envenoming in Brazil Mise, Yukari Figueroa Snake bites Patient acuity Time to treatment Brazil |
title_short |
Time to treatment and severity of snake envenoming in Brazil |
title_full |
Time to treatment and severity of snake envenoming in Brazil |
title_fullStr |
Time to treatment and severity of snake envenoming in Brazil |
title_full_unstemmed |
Time to treatment and severity of snake envenoming in Brazil |
title_sort |
Time to treatment and severity of snake envenoming in Brazil |
author |
Mise, Yukari Figueroa |
author_facet |
Mise, Yukari Figueroa Lira-da-Silva, Rejâne Maria Carvalho, Fernando Martins |
author_role |
author |
author2 |
Lira-da-Silva, Rejâne Maria Carvalho, Fernando Martins |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Mise, Yukari Figueroa Lira-da-Silva, Rejâne Maria Carvalho, Fernando Martins Mise, Yukari Figueroa Lira-da-Silva, Rejâne Maria Carvalho, Fernando Martins |
dc.subject.por.fl_str_mv |
Snake bites Patient acuity Time to treatment Brazil |
topic |
Snake bites Patient acuity Time to treatment Brazil |
description |
Objective. To analyze the relationship between time to treatment and severity of snakebite envenomation in Brazil. Methods. This case-series retrospective study analyzed 144 251 snakebite cases in Brazil between 2007 and 2015, as reported to the Brazilian Notifiable Diseases Information System. The main dependent variable was snakebite envenomation severity (mild/moderate/severe). The main predictor was time to treatment (early (< 6 hours) vs. delayed (ë 6 hours)). Covariables were snake type(Bothrops/Crotalus/Micrurus/Lachesis), patient’s age and sex, bite site, and treatment at a specialized care center (center/noncenter). Polytomous logistic regression techniques were used to control the covariates and assess confounding and effect modification. Results. The time to treatment variable was strongly associated with the severity of snakebite envenomation. Snake type and treatment at specialized care center modified the main association effect. The association between delayed time to treatment and envenomation severity was consistently stronger among patients treated at specialized care centers than among those who were not treated at such centers. Odds ratios tended to increase significantly from moderate to severe envenomation for cases within the subgroups “Center + Bothrops” (1.37 to 2.05),“No center + Bothrops” (1.25 to 1.47), “Center + Crotalus” (1.35 to 3.03), “No center + Crotalus” (0.97 to 2.72), and “Center + Lachesis” (1.22 to 1.89). Discussion. This study confirmed the classical hypothesis that the time between snakebite and initiation of medical care is associated with severity of snakebite envenomation. It is therefore necessary to provide snakebite victims early access to specialized medical care, particularly to antivenom therapy. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018 |
dc.date.accessioned.fl_str_mv |
2019-05-27T17:44:46Z |
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2019-05-27T17:44:46Z |
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Rev. Panam. Salud Publica, v. 42, p.1-6, 2018. |
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http://repositorio.ufba.br/ri/handle/ri/29678 |
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Rev. Panam. Salud Publica, v. 42, p.1-6, 2018. |
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eng |
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