Tohoku J. Exp. Med., 2022 August, 257(4)

The Role of Procalcitonin in Predicting Necessity of Antivenom Administration and Clinical Severity in Snake Bites

Ferhat Icme,¹ Akkan Avci,² Nurettin Yilmaz,² Ahmet Burak Urfalıoglu,² Begum Seyda Avci,³ Onder Yesiloglu,⁴ Mustafa Oguz Tugcan,² Hilmi Erdem Sumbul,³ Hasan Yesilagac⁵ and Ekrem Sapmaz⁶

¹Department of Emergency Medicine, Ankara City Hospital, Ankara, Turkey
²Department of Emergency Medicine, Adana City Research and Training Hospital, Health Science University, Adana, Turkey
³Department of Internal Medicine, Adana City Research and Training Hospital, Health Science University, Adana, Turkey
⁴Emergency Medicine Clinic, Mus State Hospital, Mus, Turkey
⁵Department of Emergency Medicine, Başkent University Faculty of Medicine, Adana, Turkey
⁶Department of Obstetrics and Gynecology, Health Science University, Adana, Turkey

One of the most important steps for preventing deaths due to snake bites is to administer snake antivenom to the eligible patients in a swift manner. In our study, we aimed to investigate whether procalcitonin is useful for predicting the clinical severity and the necessity of antivenom therapy at the early stages in patients presenting with snake bite. A total of 78 patients over the age of 18 who applied to the emergency department within the first 24 hours were included in this retrospective cross-sectional study. Age and sex of patients, severity of snake bites, total antivenom vials administered, observation periods and outcomes were recorded. Patients were graded according to their clinical severity after the snake bite. Procalcitonin, complete blood count and biochemical parameters of the patients were recorded. According to their clinical severity, the patients’ grades were as follows: 21 (26.9%) patients were grade 0; 21 patients (26.9%) were grade 1; 16 patients (20.5%) were grade 2; and 20 patients (25.6%) were grade 3. Snake antivenom was administered to 57 (73.1%) patients. There was a statistically significant difference between procalcitonin levels of patients in respect to their grade (P < 0.001). Sensitivity and specificity of procalcitonin levels of 13.45 and above were 100% and 100% respectively, both for the need of antivenom administration and for the blister formation in the patients. According to our study, we believe that elevated procalcitonin levels should alert the clinicians for possible blister formation, higher clinical severity, and increased requirement for antivenom administration.

Keywords —— antivenom; clinical severity; emergency; procalcitonin; snake bite

© 2022 Tohoku University Medical Press

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Tohoku J. Exp. Med 2022, 257, 291-299.

Correspondence: Ferhat Icme, M.D., Department of Emergency Medicine, Ankara City Hospital, Universiteler Mahallesi, Çankaya, Ankara 06800, Turkey.

e-mail: ferhaticme@gmail.com