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Article

Influential Factors of Local Tissue Necrosis after Taiwan Cobra Bites: A Secondary Analysis of the Clinical Significance of Venom Detection in Patients of Cobra Snakebites

1
Department of Emergency Medicine, Lin-Kou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
2
College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
3
Chang Gung Medical Education Center, Chang Gung Memorial Hospital, Taoyuan 33302, Taiwan
*
Author to whom correspondence should be addressed.
Received: 7 April 2021 / Revised: 30 April 2021 / Accepted: 5 May 2021 / Published: 7 May 2021
(This article belongs to the Special Issue Venom-Induced Tissue Damage)
Local tissue swelling, inflammation, and wound necrosis are observed in Taiwan cobra bites. Knowledge of the factors influencing local tissue necrosis after cobra bites might improve the cobra bite treatment strategy. Therefore, we aimed to explore the factors influencing local tissue necrosis after cobra bites. This was a retrospective observational cohort study. All patients clinical presentations including serum venom levels for determining the influential factors in this study were obtained from Hung et al.’s previous study. Clinical features, such as bite information, initial swelling, patient presentation time, serum venom levels, and antivenom, use were extracted. The measurement outcome was the development of wound necrosis. The factors influencing wound necrosis were investigated using univariate and logistic regression analyses. The influential factors of local tissue necrosis and their areas under the curve were: initial limb swelling, 0.88; presentation time × serum level, 0.80; initial necrosis, 0.75; patient presentation time, 0.70. Serum venom level alone cannot be used as a predictive factor. The development of tissue necrosis might be associated with the venom factor, time factor, and their interaction. These influential factors can be used in future studies to evaluate antivenom efficacy. View Full-Text
Keywords: cobra; snakebites; tissue necrosis; venom; antivenom cobra; snakebites; tissue necrosis; venom; antivenom
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MDPI and ACS Style

Lin, C.-C.; Chaou, C.-H.; Gao, S.-Y. Influential Factors of Local Tissue Necrosis after Taiwan Cobra Bites: A Secondary Analysis of the Clinical Significance of Venom Detection in Patients of Cobra Snakebites. Toxins 2021, 13, 338. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13050338

AMA Style

Lin C-C, Chaou C-H, Gao S-Y. Influential Factors of Local Tissue Necrosis after Taiwan Cobra Bites: A Secondary Analysis of the Clinical Significance of Venom Detection in Patients of Cobra Snakebites. Toxins. 2021; 13(5):338. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13050338

Chicago/Turabian Style

Lin, Chih-Chuan, Chung-Hsien Chaou, and Shi-Ying Gao. 2021. "Influential Factors of Local Tissue Necrosis after Taiwan Cobra Bites: A Secondary Analysis of the Clinical Significance of Venom Detection in Patients of Cobra Snakebites" Toxins 13, no. 5: 338. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13050338

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