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dc.contributor.authorKyi Phyu Ayeen_US
dc.contributor.authorVipa Thanachartweten_US
dc.contributor.authorChit Soeen_US
dc.contributor.authorVarunee Desakornen_US
dc.contributor.authorSupat Chamnanchanunten_US
dc.contributor.authorDuangjai Sahassanandaen_US
dc.contributor.authorThanom Supapornen_US
dc.contributor.authorVisith Sitprijaen_US
dc.contributor.otherKing Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn Universityen_US
dc.contributor.otherMahidol Universityen_US
dc.contributor.otherPhramongkutklao College of Medicineen_US
dc.contributor.otherQueen Saovabha Memorial Instituteen_US
dc.contributor.otherMedical Warden_US
dc.contributor.otherUniversity of Medicine 1en_US
dc.identifier.citationWilderness and Environmental Medicine. Vol.29, No.2 (2018), 166-175en_US
dc.description.abstract© 2018 Wilderness Medical Society Introduction: Factors predictive for death from snake envenomation vary between studies, possibly due to variation in host genetic factors and venom composition. This study aimed to evaluate predictive factors for death from snake envenomation in Myanmar. Methods: A prospective study was performed among adult patients with snakebite admitted to tertiary hospitals in Yangon, Myanmar, from May 2015 to August 2016. Data including clinical variables and laboratory parameters, management, and outcomes were evaluated. Multivariate regression analysis was performed to evaluate factors predictive for death at the time of presentation to the hospital. Results: Of the 246 patients with snake envenomation recruited into the study, 225 (92%) survived and 21 (8%) died during hospitalization. The snake species responsible for a bite was identified in 74 (30%) of the patients; the majority of bites were from Russell's vipers (63 patients, 85%). The independent factors predictive for death included 1) duration from bite to arrival at the hospital >1 h (odds ratio [OR]: 9.0, 95% confidence interval [CI]: 1.1–75.2; P=0.04); 2) white blood cell counts >20 ×103 cells·μL-1 (OR: 8.9, 95% CI: 2.3–33.7; P=0.001); and 3) the presence of capillary leakage (OR: 3.7, 95% CI: 1.2–11.2; P=0.02). A delay in antivenom administration >4 h increases risk of death (11/21 deaths). Conclusions: Patients who present with these independent predictive factors should be recognized and provided with early appropriate intervention to reduce the mortality rate among adults with snake envenomation in Myanmar.en_US
dc.rightsMahidol Universityen_US
dc.titlePredictive Factors for Death After Snake Envenomation in Myanmaren_US
Appears in Collections:Scopus 2018

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