Factors Associated with Systemic Bleeding in Bothrops Envenomation in a Tertiary Hospital in the Brazilian Amazon
Bothrops snakebites usually present systemic bleeding, and the clinical–epidemiological and laboratorial factors associated with the development of this manifestation are not well established. In this study, we assessed the prevalence of Bothrops snakebites with systemic bleeding reported...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2019-01-01
|
| Series: | Toxins |
| Subjects: | |
| Online Access: | http://www.mdpi.com/2072-6651/11/1/22 |
| _version_ | 1818005620938244096 |
|---|---|
| author | Sâmella S. Oliveira Eliane C. Alves Alessandra S. Santos João Pedro T. Pereira Lybia Kássia S. Sarraff Elizandra F. Nascimento José Diego de-Brito-Sousa Vanderson S. Sampaio Marcus V.G. Lacerda Jacqueline A.G. Sachett Ida S. Sano-Martins Wuelton M. Monteiro |
| author_facet | Sâmella S. Oliveira Eliane C. Alves Alessandra S. Santos João Pedro T. Pereira Lybia Kássia S. Sarraff Elizandra F. Nascimento José Diego de-Brito-Sousa Vanderson S. Sampaio Marcus V.G. Lacerda Jacqueline A.G. Sachett Ida S. Sano-Martins Wuelton M. Monteiro |
| author_sort | Sâmella S. Oliveira |
| collection | DOAJ |
| description | Bothrops snakebites usually present systemic bleeding, and the clinical–epidemiological and laboratorial factors associated with the development of this manifestation are not well established. In this study, we assessed the prevalence of Bothrops snakebites with systemic bleeding reported at the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, in Manaus, Amazonas State, Brazil, and the clinical–epidemiological and laboratorial factors associated with systemic bleeding. This is an observational, cross-sectional study carried out between August, 2013 and July, 2016. Patients who developed systemic bleeding on admission or during hospitalization were considered cases, and those with non-systemic bleeding were included in the control group. Systemic bleeding was observed in 63 (15.3%) of the 442 Bothrops snakebites evaluated. Bothrops snakebites mostly occurred in males (78.2%), in rural areas (89.0%) and in the age group of 11 to 30 years old (40.4%). It took most of the patients (59.8%) less than 3 h to receive medical assistance. Unclottable blood (AOR = 3.11 (95% CI = 1.53 to 6.31; p = 0.002)) and thrombocytopenia (AOR = 4.52 (95% CI = 2.03 to 10.09; p < 0.001)) on admission were independently associated with systemic bleeding during hospitalization. These hemostatic disorders on admission increase the chances of systemic bleeding during hospitalization. Prospective studies are needed to clarify the pathophysiology of systemic bleeding in Bothrops snakebites in the Amazon region. |
| first_indexed | 2024-04-14T04:47:24Z |
| format | Article |
| id | doaj.art-8d010b6b57274eee8ffe9813e6500aa9 |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-04-14T04:47:24Z |
| publishDate | 2019-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-8d010b6b57274eee8ffe9813e6500aa92022-12-22T02:11:25ZengMDPI AGToxins2072-66512019-01-011112210.3390/toxins11010022toxins11010022Factors Associated with Systemic Bleeding in Bothrops Envenomation in a Tertiary Hospital in the Brazilian AmazonSâmella S. Oliveira0Eliane C. Alves1Alessandra S. Santos2João Pedro T. Pereira3Lybia Kássia S. Sarraff4Elizandra F. Nascimento5José Diego de-Brito-Sousa6Vanderson S. Sampaio7Marcus V.G. Lacerda8Jacqueline A.G. Sachett9Ida S. Sano-Martins10Wuelton M. Monteiro11Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, BrazilEscola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, BrazilInstituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, BrazilInstituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, BrazilInstituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, BrazilInstituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, BrazilEscola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, BrazilEscola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, BrazilInstituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, BrazilEscola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, BrazilLaboratório de Fisiopatologia, Instituto Butantan, São Paulo 05503-900, BrazilEscola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, BrazilBothrops snakebites usually present systemic bleeding, and the clinical–epidemiological and laboratorial factors associated with the development of this manifestation are not well established. In this study, we assessed the prevalence of Bothrops snakebites with systemic bleeding reported at the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, in Manaus, Amazonas State, Brazil, and the clinical–epidemiological and laboratorial factors associated with systemic bleeding. This is an observational, cross-sectional study carried out between August, 2013 and July, 2016. Patients who developed systemic bleeding on admission or during hospitalization were considered cases, and those with non-systemic bleeding were included in the control group. Systemic bleeding was observed in 63 (15.3%) of the 442 Bothrops snakebites evaluated. Bothrops snakebites mostly occurred in males (78.2%), in rural areas (89.0%) and in the age group of 11 to 30 years old (40.4%). It took most of the patients (59.8%) less than 3 h to receive medical assistance. Unclottable blood (AOR = 3.11 (95% CI = 1.53 to 6.31; p = 0.002)) and thrombocytopenia (AOR = 4.52 (95% CI = 2.03 to 10.09; p < 0.001)) on admission were independently associated with systemic bleeding during hospitalization. These hemostatic disorders on admission increase the chances of systemic bleeding during hospitalization. Prospective studies are needed to clarify the pathophysiology of systemic bleeding in Bothrops snakebites in the Amazon region.http://www.mdpi.com/2072-6651/11/1/22hemostatic disordersunclottable bloodthrombocytopeniaBothrops atrox |
| spellingShingle | Sâmella S. Oliveira Eliane C. Alves Alessandra S. Santos João Pedro T. Pereira Lybia Kássia S. Sarraff Elizandra F. Nascimento José Diego de-Brito-Sousa Vanderson S. Sampaio Marcus V.G. Lacerda Jacqueline A.G. Sachett Ida S. Sano-Martins Wuelton M. Monteiro Factors Associated with Systemic Bleeding in Bothrops Envenomation in a Tertiary Hospital in the Brazilian Amazon Toxins hemostatic disorders unclottable blood thrombocytopenia Bothrops atrox |
| title | Factors Associated with Systemic Bleeding in Bothrops Envenomation in a Tertiary Hospital in the Brazilian Amazon |
| title_full | Factors Associated with Systemic Bleeding in Bothrops Envenomation in a Tertiary Hospital in the Brazilian Amazon |
| title_fullStr | Factors Associated with Systemic Bleeding in Bothrops Envenomation in a Tertiary Hospital in the Brazilian Amazon |
| title_full_unstemmed | Factors Associated with Systemic Bleeding in Bothrops Envenomation in a Tertiary Hospital in the Brazilian Amazon |
| title_short | Factors Associated with Systemic Bleeding in Bothrops Envenomation in a Tertiary Hospital in the Brazilian Amazon |
| title_sort | factors associated with systemic bleeding in bothrops envenomation in a tertiary hospital in the brazilian amazon |
| topic | hemostatic disorders unclottable blood thrombocytopenia Bothrops atrox |
| url | http://www.mdpi.com/2072-6651/11/1/22 |
| work_keys_str_mv | AT samellasoliveira factorsassociatedwithsystemicbleedinginbothropsenvenomationinatertiaryhospitalinthebrazilianamazon AT elianecalves factorsassociatedwithsystemicbleedinginbothropsenvenomationinatertiaryhospitalinthebrazilianamazon AT alessandrassantos factorsassociatedwithsystemicbleedinginbothropsenvenomationinatertiaryhospitalinthebrazilianamazon AT joaopedrotpereira factorsassociatedwithsystemicbleedinginbothropsenvenomationinatertiaryhospitalinthebrazilianamazon AT lybiakassiassarraff factorsassociatedwithsystemicbleedinginbothropsenvenomationinatertiaryhospitalinthebrazilianamazon AT elizandrafnascimento factorsassociatedwithsystemicbleedinginbothropsenvenomationinatertiaryhospitalinthebrazilianamazon AT josediegodebritosousa factorsassociatedwithsystemicbleedinginbothropsenvenomationinatertiaryhospitalinthebrazilianamazon AT vandersonssampaio factorsassociatedwithsystemicbleedinginbothropsenvenomationinatertiaryhospitalinthebrazilianamazon AT marcusvglacerda factorsassociatedwithsystemicbleedinginbothropsenvenomationinatertiaryhospitalinthebrazilianamazon AT jacquelineagsachett factorsassociatedwithsystemicbleedinginbothropsenvenomationinatertiaryhospitalinthebrazilianamazon AT idassanomartins factorsassociatedwithsystemicbleedinginbothropsenvenomationinatertiaryhospitalinthebrazilianamazon AT wueltonmmonteiro factorsassociatedwithsystemicbleedinginbothropsenvenomationinatertiaryhospitalinthebrazilianamazon |