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Is coagulopathy a common consequence of a Vipera berus bite? A retrospective single centre study.
Ann Agric Environ Med. 2018 Dec 20; 25(4):630-634.AA

Abstract

INTRODUCTION

The Vipera berus (common viper) is the only species of venomous snake found in Poland. The aim of this study was to determine to what extent coagulopathy has occurred as a post-bite complication.

MATERIAL AND METHODS

The medical records of 138 adult patients in the Sucha Beskidzka hospital with the diagnosis of snake bite between 2001-2014 were retrospectively analyzed. Demographic, clinical and laboratory data were collected. Antivenom was given to all patients, except one, with snake bites, but laboratory test were taken prior to administration of antivenom. Obtained results were compared to those of the control group, composed of 176 adults hospitalized in the same period for an elective laparoscopic cholecystectomy.

RESULTS

The mean platelet count in the study group was 239.94×109/L (SD=56.56) and 248.77×109/L (SD=57.82) in the control group. In 98% of the study group and 100% of the control group the platelet value (PLT) fell within laboratory norms (130 to 420×109/L), 2 patients after snake bites had a PLT lower than normal, and thrombocytosis was not observed in either group. A reference range of 0.85-1.3 INR below normal was found in 2 patients in the study group and 15 from the control group, while values above the normal range were found in 8 patients (6.7%) from the snake bite group and no patients from the control group. In the study group, the INR ranged from 0.78-1.43 with a mean of 1.046 (SD=0.14), while in the control group the range was from 0.79-1.28, with a mean of 0.95 (SD=0.08). There was a significant difference in INR between the study and control groups (p<0.0001).

CONCLUSIONS

The bite from V. berus does not result in severe thrombocytopenia, with only a moderate increase in INR values observed in about 7% of patients.

Authors+Show Affiliations

Department of General Surgery John Gawlik Hospital, Sucha Beskidzka, Poland. kadgta@interia.pl.First Department of General, Oncological & Gastroenterological Surgery Jagiellonian University Medical College, Cracow, Poland. dianahz@poczta.onet.pl.Jagiellonian University Medical College, Cracow, Poland. justyna.zybaczynska@gmail.com.First Department of General, Oncological & Gastroenterological Surgery Jagiellonian University Medical College, Cracow, Poland. antoni.szczepanik@uj.edu.pl.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30586978

Citation

Dyląg-Trojanowska, Katarzyna Elżbieta, et al. "Is Coagulopathy a Common Consequence of a Vipera Berus Bite? a Retrospective Single Centre Study." Annals of Agricultural and Environmental Medicine : AAEM, vol. 25, no. 4, 2018, pp. 630-634.
Dyląg-Trojanowska KE, Hodorowicz-Zaniewska D, Zybaczyńska J, et al. Is coagulopathy a common consequence of a Vipera berus bite? A retrospective single centre study. Ann Agric Environ Med. 2018;25(4):630-634.
Dyląg-Trojanowska, K. E., Hodorowicz-Zaniewska, D., Zybaczyńska, J., & Szczepanik, A. M. (2018). Is coagulopathy a common consequence of a Vipera berus bite? A retrospective single centre study. Annals of Agricultural and Environmental Medicine : AAEM, 25(4), 630-634. https://doi.org/10.26444/aaem/75941
Dyląg-Trojanowska KE, et al. Is Coagulopathy a Common Consequence of a Vipera Berus Bite? a Retrospective Single Centre Study. Ann Agric Environ Med. 2018 Dec 20;25(4):630-634. PubMed PMID: 30586978.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is coagulopathy a common consequence of a Vipera berus bite? A retrospective single centre study. AU - Dyląg-Trojanowska,Katarzyna Elżbieta, AU - Hodorowicz-Zaniewska,Diana, AU - Zybaczyńska,Justyna, AU - Szczepanik,Antoni M, Y1 - 2017/10/16/ PY - 2018/12/28/entrez PY - 2018/12/28/pubmed PY - 2019/1/12/medline KW - Poland KW - Vipera berus bite KW - antivenom KW - coagulopathy KW - envenomation KW - snake KW - snakebite KW - thrombocytopenia KW - venom SP - 630 EP - 634 JF - Annals of agricultural and environmental medicine : AAEM JO - Ann Agric Environ Med VL - 25 IS - 4 N2 - INTRODUCTION: The Vipera berus (common viper) is the only species of venomous snake found in Poland. The aim of this study was to determine to what extent coagulopathy has occurred as a post-bite complication. MATERIAL AND METHODS: The medical records of 138 adult patients in the Sucha Beskidzka hospital with the diagnosis of snake bite between 2001-2014 were retrospectively analyzed. Demographic, clinical and laboratory data were collected. Antivenom was given to all patients, except one, with snake bites, but laboratory test were taken prior to administration of antivenom. Obtained results were compared to those of the control group, composed of 176 adults hospitalized in the same period for an elective laparoscopic cholecystectomy. RESULTS: The mean platelet count in the study group was 239.94×109/L (SD=56.56) and 248.77×109/L (SD=57.82) in the control group. In 98% of the study group and 100% of the control group the platelet value (PLT) fell within laboratory norms (130 to 420×109/L), 2 patients after snake bites had a PLT lower than normal, and thrombocytosis was not observed in either group. A reference range of 0.85-1.3 INR below normal was found in 2 patients in the study group and 15 from the control group, while values above the normal range were found in 8 patients (6.7%) from the snake bite group and no patients from the control group. In the study group, the INR ranged from 0.78-1.43 with a mean of 1.046 (SD=0.14), while in the control group the range was from 0.79-1.28, with a mean of 0.95 (SD=0.08). There was a significant difference in INR between the study and control groups (p<0.0001). CONCLUSIONS: The bite from V. berus does not result in severe thrombocytopenia, with only a moderate increase in INR values observed in about 7% of patients. SN - 1898-2263 UR - https://www.unboundmedicine.com/medline/citation/30586978/Is_coagulopathy_a_common_consequence_of_a_Vipera_berus_bite_A_retrospective_single_centre_study_ L2 - https://doi.org/10.26444/aaem/75941 DB - PRIME DP - Unbound Medicine ER -