Factores de riesgo de severidad en accidentes ofídicos, Hospital Francisco de Ycaza Bustamante, 2010-2013
Fecha
2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El accidente ofídico es la lesión resultante de la mordedura de una serpiente, en
países con ambiente apropiado, condiciones climáticas, socioculturales y demográficas
que aumentan la posibilidad de sufrir agresión, favoreciendo la morbilidad y mortalidad
de personas. Objetivo: Analizar factores de riesgo de severidad en ofidismo de
pacientes del área de Emergencia del Hospital Ycaza Bustamante entre 2010-2013.
Materiales y métodos: Estudio de enfoque cuantitativo, analítico, observacional de tipo
de casos y controles, retrospectivo. Se consultó61 registros médicos de pacientes
atendidos entre enero 2010 a diciembre 2013. Información recopilada y analizada en
Microsoft Excel. Resultados: En frecuencia: Grupo etario: 11-15 años (49.18%),
varones (52,46%) rurales (90.16%), procedentes de Guayas (44.26%) y Los Ríos
(29.51%). Las extremidades inferiores (80,32%) resultaron más afectas. 28 pacientes
(45,9%) obtuvieron atención médica pasadas 6 horas del accidente; 30 (49.18%)
recibieron APH no médica. El envenenamiento moderado fue el más frecuente
(60.66%).Se usó SAO en 57 pacientes (93.44%); 31 (52.63%) después de 6 horas.26
pacientes (42,62%) desarrollaron complicaciones; siendo frecuentes: necrosis local y
anemia hemorrágica. Al contraste univariable, la APH no médica (OR: 4.31; p=0.0069);
la mordedura en extremidades superiores (OR 3.93; p= 0.05) y la atención médica > 6
horas (OR 5.63; p= 0.0016) tuvieron relación con complicaciones. El uso de torniquete
se asoció a complicaciones locales (OR 3.14; p= 0.05; 1 GL). Conclusiones: En la
muestra estudiada existen factores de riesgo que favorecen complicaciones
Ophidism is an injury resulting from a snake bite, in countries with appropriate habitat environments, with climatic, sociocultural and demographic conditions that increase the possibility of aggression, favoring the morbidity and mortality of humans and animals. Objective: To identify and analyze risk factors for severity in ophidism of patients in the Emergency Area of the Francisco Ycaza Bustamante Hospital among 2010-2013. Materials and methods: Analytical case control study, quantitative and retrospective design. 61 medical records of patients attended between January 2010 and December 2013 were consulted. Information was compiled and analyzed in Microsoft Excel. Results: The most frequent age group was 11-15 years old (49.18%), men (52.46%) rural (90.16%), from Guayas (44.26%) and Los Ríos (29.51%). The lower limbs (80.32%) were more affected. 28 patients (45.9%) received medical attention after 6 hours of the accident; 30 (49.18%) received non medical PHA. Moderate poisoning was the most frequent (60.66%). Anti-venom was used in 57 patients (93.44%); 31 (52.63%) after 6 hours. 26 patients (42.62%) developed complications; being frequent: local necrosis and hemorrhagic anemia. At univariate contrast, the non-medical PHA (OR: 4.31, p = 0.0069), bite in upper limbs (OR 3.93, p = 0.05) and medical care> 6 hours (OR 5.63; p = 0.0016) were related to complications. The use of tourniquet was associated with local complications (OR 3.14; p = 0.05; 1 GL). Conclusions: In the studied sample there are risk factors that favor complications.
Ophidism is an injury resulting from a snake bite, in countries with appropriate habitat environments, with climatic, sociocultural and demographic conditions that increase the possibility of aggression, favoring the morbidity and mortality of humans and animals. Objective: To identify and analyze risk factors for severity in ophidism of patients in the Emergency Area of the Francisco Ycaza Bustamante Hospital among 2010-2013. Materials and methods: Analytical case control study, quantitative and retrospective design. 61 medical records of patients attended between January 2010 and December 2013 were consulted. Information was compiled and analyzed in Microsoft Excel. Results: The most frequent age group was 11-15 years old (49.18%), men (52.46%) rural (90.16%), from Guayas (44.26%) and Los Ríos (29.51%). The lower limbs (80.32%) were more affected. 28 patients (45.9%) received medical attention after 6 hours of the accident; 30 (49.18%) received non medical PHA. Moderate poisoning was the most frequent (60.66%). Anti-venom was used in 57 patients (93.44%); 31 (52.63%) after 6 hours. 26 patients (42.62%) developed complications; being frequent: local necrosis and hemorrhagic anemia. At univariate contrast, the non-medical PHA (OR: 4.31, p = 0.0069), bite in upper limbs (OR 3.93, p = 0.05) and medical care> 6 hours (OR 5.63; p = 0.0016) were related to complications. The use of tourniquet was associated with local complications (OR 3.14; p = 0.05; 1 GL). Conclusions: In the studied sample there are risk factors that favor complications.
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MORDEDURAS DE SERPIENTES, ENVENENAMIENTO, EPIDEMIOLOGÍA DESCRIPTIVA, ESTUDIOS RETROSPECTIVOS, HOSPITAL DEL NIÑO FRANCISCO DE ICAZA BUSTAMANTE, FACTORES DE RIESGO, CANTÓN GUAYAQUIL, ECUADOR