Article Text
Abstract
Objectives Although devastating acute effects associated with snake envenoming are well described, the long-term sequelae resulting from these envenomings have not been adequately addressed, especially in the paediatric population. The aim of our study is to describe the clinical characteristics among paediatric patients in Costa Rica who developed long-term sequelae secondary to snakebite envenoming.
Design Retrospective descriptive study of paediatric patients under 13 years who were admitted with a history of a recent snakebite at the National Children’s Hospital in Costa Rica from January 2001 to December 2014.
Results We enrolled 74 patients admitted to our centre due to envenoming, and separated those who did not develop sequelae (50 patients) from those who did (24 patients). Of those who presented acute complications during hospitalisation, local wound infection and clinically diagnosed compartmental syndrome were significantly higher in the group that developed sequelae thereafter. Hypertrophic scars (66.7%), functional limitation of affected limb (37.5%) and the need of skin graft (37.5%) were the most common sequelae. The median follow-up of patients with long-term sequelae after discharge was 25.4 months (5.6–59.4). No deaths were reported during this time period.
Conclusions Given the high economic, personal and healthcare burden that entails follow-up of these patients, efforts should be carried out to prevent the factors associated with sequelae among the affected population.
- epidemiology
- toxicology
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Footnotes
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Contributors HB-C and Ávila-Agüero conceptualized and designed the study and data collection instruments. They collected data, carried out the initial analyses, drafted and reviewed the manuscript. JMG contributed to the study design and the initial analyses. He critically reviewed the manuscript for intellectual content. KC-B, AS-F, RU-G, and KV collected data, and were in charge of patients during hospitalization and follow up. They reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval This study was approved by the Bioethical and Research Committee of the National Children’s Hospital, CLOBI-HNN, project 001-2015.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information. If questions or requests for additional information, please contact corresponding author.