Epidemiology and clinical outcomes of snakebite in the elderly: a ToxIC database study*

Meghan B. Spyres, Anne Michelle Ruha, Kurt Kleinschmidt, Rais Vohra, Eric Smith, Angela Padilla-Jones

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Epidemiologic studies of snakebites in the United States report typical victims to be young men. Little is known regarding other demographics including children and the elderly. The objective of this study was to describe the epidemiology and clinical manifestations of snake bite in elderly patients reported to the ToxIC (Toxicology Investigators Consortium) North American Snakebite Registry (NASBR) Methods: This was a multicenter analysis of a prospectively collected cohort of patients with snakebite reported to the ToxIC NASBR between 1 January 2013 and 31 December 2015. Inclusion criterion was age >65. Variables collected included patient demographics, medical comorbidities, medications, date the case was reported to the registry, location of exposure, bite location, snake species, clinical manifestations, outcomes, and management. Results: Of the 450 cases reported, 30 (6.7%) occurred in elderly patients, with an average age of 74 years. Rattlesnake envenomations were common (93.3%). The majority of patients were men (66.7%) and reported at least one medical comorbidity (83.3%). Most patients were on cardiac medications (60%) and use of antiplatelet or anticoagulant medications was common (33%). Hemotoxicity occurred in 30% of patients on initial presentation and 11.5% of patients on initial follow-up. No clinically significant early or late bleeding was observed. Conclusions: Elderly patients with North American snake envenomation are likely to have co-morbidities and to take medications that may increase their risk for hemotoxicity, however risk of bleeding or other complications was not increased in this group.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalClinical Toxicology
DOIs
StateAccepted/In press - Jul 14 2017

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Snake Bites
Epidemiology
Toxicology
Research Personnel
Databases
Anticoagulants
Registries
Comorbidity
Demography
Hemorrhage
Crotalus
Epidemiologic Studies
Morbidity

Keywords

  • elderly
  • rattlesnake
  • risk factor
  • Snakebite
  • ToxIC

ASJC Scopus subject areas

  • Toxicology

Cite this

Epidemiology and clinical outcomes of snakebite in the elderly : a ToxIC database study*. / Spyres, Meghan B.; Ruha, Anne Michelle; Kleinschmidt, Kurt; Vohra, Rais; Smith, Eric; Padilla-Jones, Angela.

In: Clinical Toxicology, 14.07.2017, p. 1-5.

Research output: Contribution to journalArticle

Spyres, Meghan B. ; Ruha, Anne Michelle ; Kleinschmidt, Kurt ; Vohra, Rais ; Smith, Eric ; Padilla-Jones, Angela. / Epidemiology and clinical outcomes of snakebite in the elderly : a ToxIC database study*. In: Clinical Toxicology. 2017 ; pp. 1-5.
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abstract = "Introduction: Epidemiologic studies of snakebites in the United States report typical victims to be young men. Little is known regarding other demographics including children and the elderly. The objective of this study was to describe the epidemiology and clinical manifestations of snake bite in elderly patients reported to the ToxIC (Toxicology Investigators Consortium) North American Snakebite Registry (NASBR) Methods: This was a multicenter analysis of a prospectively collected cohort of patients with snakebite reported to the ToxIC NASBR between 1 January 2013 and 31 December 2015. Inclusion criterion was age >65. Variables collected included patient demographics, medical comorbidities, medications, date the case was reported to the registry, location of exposure, bite location, snake species, clinical manifestations, outcomes, and management. Results: Of the 450 cases reported, 30 (6.7{\%}) occurred in elderly patients, with an average age of 74 years. Rattlesnake envenomations were common (93.3{\%}). The majority of patients were men (66.7{\%}) and reported at least one medical comorbidity (83.3{\%}). Most patients were on cardiac medications (60{\%}) and use of antiplatelet or anticoagulant medications was common (33{\%}). Hemotoxicity occurred in 30{\%} of patients on initial presentation and 11.5{\%} of patients on initial follow-up. No clinically significant early or late bleeding was observed. Conclusions: Elderly patients with North American snake envenomation are likely to have co-morbidities and to take medications that may increase their risk for hemotoxicity, however risk of bleeding or other complications was not increased in this group.",
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