Incidence of Delayed and Recurrent Coagulopathies in North American Rattlesnake Bite Patients Initially Treated with Crotalidae Polyvalent Immune Fab (ovine) (CroFab)

Persistent Link:
http://hdl.handle.net/10150/614099
Title:
Incidence of Delayed and Recurrent Coagulopathies in North American Rattlesnake Bite Patients Initially Treated with Crotalidae Polyvalent Immune Fab (ovine) (CroFab)
Author:
Moench, Jaci; Boesen, Keith
Affiliation:
College of Pharmacy, The University of Arizona
Issue Date:
2015
Rights:
Copyright © is held by the author.
Collection Information:
This item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Associate Librarian and Clinical Instructor, Pharmacy Practice and Science, jenmartin@email.arizona.edu.
Publisher:
The University of Arizona.
Abstract:
Objectives: To determine the incidence of late coagulopathy and characterize those requiring antivenom retreatment among rattlesnake envenomation patients managed by the Arizona Poison and Drug Information Center (APDIC). Methods: This descriptive, retrospective chart review used data extracted from APDIC charts. Data included coagulopathy lab values recorded during treatment, vials of antivenom required to achieve initial control, total vials during therapy, incidence of initial coagulopathy, use of extended infusion, time until treatment, and permanent sequelae due to snakebite. Demographic information was also recorded. Late coagulopathy is defined as coagulopathy occurring after completion of maintenance dosing, and can be considered recurrent or delayed. Delayed coagulopathy occurs in the absence of an initial coagulopathy, while recurrent coagulopathy requires an initial event previously controlled by antivenom therapy. Results: Of 321 identified reports, 120 patients were treated with antivenom, had outpatient follow-up, and were included in analysis. Sixty-one (50.8%) patients did not have an initial coagulopathy, while 59 (49.2%) had an initial coagulopathy. Late coagulopathy occurred in 63 (52.5%) of patients. Delayed coagulopathies occurred in 19 (31.1%) of patients with no initial coagulopathy; Of those with an initial coagulopathy, recurrent coagulopathies occurred in 44 (74.5%) of patients. Patients with initial coagulopathy were statistically more likely to develop a late coagulopathy than those with no initial coagulopathy (p<0.001). Seventeen patients required retreatment post-discharge. Conclusions: Patients envenomated by rattlesnakes are at high risk for developing late coagulopathies. Close outpatient follow-up is imperative for monitoring of coagulopathies. Need for retreatment with FabAV post-discharge is not uncommon.
Description:
Class of 2015 Abstract
Keywords:
bite; coagulopathies; North American rattlesnake; crotalidae polyvalent immune Fab (ovine) (CroFab); Arizona Poison and Drug Information Center (APDIC)
Advisor:
Boesen, Keith

Full metadata record

DC FieldValue Language
dc.contributor.advisorBoesen, Keithen
dc.contributor.authorMoench, Jacien
dc.contributor.authorBoesen, Keithen
dc.date.accessioned2016-06-22T15:37:31Z-
dc.date.available2016-06-22T15:37:31Z-
dc.date.issued2015-
dc.identifier.urihttp://hdl.handle.net/10150/614099-
dc.descriptionClass of 2015 Abstracten
dc.description.abstractObjectives: To determine the incidence of late coagulopathy and characterize those requiring antivenom retreatment among rattlesnake envenomation patients managed by the Arizona Poison and Drug Information Center (APDIC). Methods: This descriptive, retrospective chart review used data extracted from APDIC charts. Data included coagulopathy lab values recorded during treatment, vials of antivenom required to achieve initial control, total vials during therapy, incidence of initial coagulopathy, use of extended infusion, time until treatment, and permanent sequelae due to snakebite. Demographic information was also recorded. Late coagulopathy is defined as coagulopathy occurring after completion of maintenance dosing, and can be considered recurrent or delayed. Delayed coagulopathy occurs in the absence of an initial coagulopathy, while recurrent coagulopathy requires an initial event previously controlled by antivenom therapy. Results: Of 321 identified reports, 120 patients were treated with antivenom, had outpatient follow-up, and were included in analysis. Sixty-one (50.8%) patients did not have an initial coagulopathy, while 59 (49.2%) had an initial coagulopathy. Late coagulopathy occurred in 63 (52.5%) of patients. Delayed coagulopathies occurred in 19 (31.1%) of patients with no initial coagulopathy; Of those with an initial coagulopathy, recurrent coagulopathies occurred in 44 (74.5%) of patients. Patients with initial coagulopathy were statistically more likely to develop a late coagulopathy than those with no initial coagulopathy (p<0.001). Seventeen patients required retreatment post-discharge. Conclusions: Patients envenomated by rattlesnakes are at high risk for developing late coagulopathies. Close outpatient follow-up is imperative for monitoring of coagulopathies. Need for retreatment with FabAV post-discharge is not uncommon.en
dc.language.isoen_USen
dc.publisherThe University of Arizona.en
dc.rightsCopyright © is held by the author.en
dc.subjectbiteen
dc.subjectcoagulopathiesen
dc.subjectNorth American rattlesnakeen
dc.subjectcrotalidae polyvalent immune Fab (ovine) (CroFab)en
dc.subjectArizona Poison and Drug Information Center (APDIC)en
dc.titleIncidence of Delayed and Recurrent Coagulopathies in North American Rattlesnake Bite Patients Initially Treated with Crotalidae Polyvalent Immune Fab (ovine) (CroFab)en_US
dc.typetexten
dc.typeElectronic Reporten
dc.contributor.departmentCollege of Pharmacy, The University of Arizonaen
dc.description.collectioninformationThis item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Associate Librarian and Clinical Instructor, Pharmacy Practice and Science, jenmartin@email.arizona.edu.en
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