Availability of erythrocyte sedimentation rate as a predictor of venom induced coagulopathy in patients with snakebite

Heo, Han; Moon, Hyung Jun; Shin, Tae Yong; Lee, Dong Wook; Jeong, Dong Kil; Kim, Hyun Joon; Lee, Hyun Jung

J Korean Soc Emerg Med > Volume 34(4); 2023 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2023;34(4): 305-313.

독사교상 환자의 응고병증 예측인자로서의 적혈구침강속도 측정의 유용성

허 한

순천향대학교 부속 천안병원 응급의학과

Availability of erythrocyte sedimentation rate as a predictor of venom induced coagulopathy in patients with snakebite

Department of Emergency Medicine, Soonchunhyang University Hospital, Cheonan, Korea

Correspondence

Hyung Jun Moon ,Tel: 041-570-2299, Fax: 41-570-3851, Email: raintree@schmc.ac.kr,

Received: August 11, 2022; Revised: October 12, 2022 Accepted: October 21, 2022. Published online: August 31, 2023.

ABSTRACT

Objective:
Venom-induced coagulopathy (VIC) is a common snakebite complication that can cause life-threatening hemorrhage. Previous studies have shown that snake venom can cause a decrease in the erythrocyte sedimentation rate (ESR), but this has not been investigated in actual clinical practice. This study evaluated the clinical utility of erythrocyte sedimentation rate as a predictive factor for VIC in patients with a poisonous snakebite.
Method:
From January 2012 to December 2021, this study performed a retrospective study of patients with venomous snakebites presenting to a tertiary emergency department. The demographic and laboratory data were collected through a chart review. The patients were divided into two groups, VIC and NoVIC groups. Logistic regression analysis was performed to identify the factors that predicted the presence of VIC, and the receiver operating characteristic (ROC) curve was drawn.
Results:
One hundred and fifty-three patients were enrolled, and 31 patients (20.3%) developed VIC. The VIC group had significantly lower ESR than the NoVIC group (5.1±5.6 vs. 14.8±13.8; P<0.001). Logistic regression analysis showed that the decreased ESR was associated with the occurrence of coagulopathy (odds ratio, 0.957; 95% confidence interval, 0.917-0.999; P=0.045). The area under the curve was 0.701 in the ROC curve, and the cutoff value was set to 4.5 mm/hr.
Conclusion:
ESR measured upon arrival at the emergency department was available to predict venom-induced coagulopathy in snakebite patients.

Key words: Erythrocyte sedimentation; Snake bites; Diagnosis; Blood coagulation factors