Association between diabetes and disease severity in patients with venomous snakebites: A Multicenter Retrospective Analysis.

IF 3.4 2区医学 Q1 PARASITOLOGY

PLoS Neglected Tropical Diseases Pub Date : 2025-04-23 eCollection Date: 2025-04-01 DOI:10.1371/journal.pntd.0012975

Miaomiao Zhang, Xiuyan Peng, Feng Chen, Qi Li

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引用次数: 0

Abstract

Objective: Snakebites remain an overlooked public health issue with high morbidity and mortality. In this study, we assess the impact of diabetes on disease severity in patients with venomous snakebites.

Methods: A retrospective cohort analysis was conducted on snakebite cases treated at eight hospitals in Fujian Province between December 2019 and December 2023. Snakebite severity was evaluated using the Snakebite Severity Score. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with snakebite severity.

Results: The study included 537 patients. The average age of patients is 55 years. 54.93% (n = 295) were aged ≥55 years, 57.17% (n = 307) were male, and 13.41% (n = 72) had diabetes. In the multivariate logistic regression, diabetes (odds ratio [OR] = 5.51; 95% confidence interval [CI]: 3.18-9.55), time from snakebite to hospital (OR = 1.04; 95% CI: 1.01-1.07), and bite site (OR = 0.63; 95% CI: 0.41-0.97) were identified as independent predictors of snakebite severity. Subgroup analysis revealed significant sex differences among patients with diabetes. The odds ratio for moderate-to-severe outcome was 3.81 (95% confidence interval [CI]: 1.81-7.99) in males and 12.57 (95% CI: 5.72-27.60) in females, with an interaction p-value of 0.030. Additionally, diabetes was significantly associated with prolonged hospital length of stay (p < 0.01), increased costs (p < 0.01), higher complication rates (p < 0.01), and a greater likelihood of requiring debridement surgery (p < 0.01) compared to individuals without diabetes.

Conclusion: Diabetes is an independent predictor of disease severity in patients with snakebites, underscoring the need for clinicians to consider the diabetes status when assessing and managing snakebite risk. These findings provide valuable insights for optimizing care strategies for individuals with diabetes who have experienced venomous snakebites.

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毒蛇咬伤患者糖尿病与疾病严重程度的关系：一项多中心回顾性分析

目的：蛇咬伤仍然是一个被忽视的公共卫生问题，具有高发病率和死亡率。在这项研究中，我们评估了糖尿病对毒蛇咬伤患者疾病严重程度的影响。方法：对福建省8家医院2019年12月至2023年12月收治的蛇咬伤病例进行回顾性队列分析。使用蛇咬伤严重程度评分评估蛇咬伤严重程度。进行单因素和多因素logistic回归分析，以确定与蛇咬伤严重程度相关的因素。结果：纳入537例患者。患者的平均年龄为55岁。年龄≥55岁者占54.93% (n = 295)，男性占57.17% (n = 307)，糖尿病患者占13.41% （n = 72）。在多因素logistic回归中，糖尿病(优势比[OR] = 5.51；95%可信区间[CI]: 3.18-9.55)，从蛇咬伤到医院的时间(OR = 1.04；95% CI: 1.01-1.07)，咬伤部位(OR = 0.63；95% CI: 0.41-0.97)被确定为蛇咬伤严重程度的独立预测因子。亚组分析显示糖尿病患者的性别差异显著。男性中度至重度结局的优势比为3.81(95%可信区间[CI]: 1.81-7.99)，女性为12.57 (95% CI: 5.72-27.60)，相互作用p值为0.030。此外，与非糖尿病患者相比，糖尿病患者的住院时间延长（p < 0.01）、费用增加（p < 0.01）、并发症发生率增加（p < 0.01）以及需要清创手术的可能性增加（p < 0.01）显著相关。结论：糖尿病是蛇咬伤患者疾病严重程度的独立预测因子，强调临床医生在评估和管理蛇咬伤风险时需要考虑糖尿病状况。这些发现为优化患有毒蛇咬伤的糖尿病患者的护理策略提供了有价值的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PLoS Neglected Tropical Diseases PARASITOLOGY-TROPICAL MEDICINE

自引率

10.50%

发文量

723

期刊介绍： PLOS Neglected Tropical Diseases publishes research devoted to the pathology, epidemiology, prevention, treatment and control of the neglected tropical diseases (NTDs), as well as relevant public policy. The NTDs are defined as a group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of low-income and middle-income countries. Their impact on child health and development, pregnancy, and worker productivity, as well as their stigmatizing features limit economic stability. All aspects of these diseases are considered, including: Pathogenesis Clinical features Pharmacology and treatment Diagnosis Epidemiology Vector biology Vaccinology and prevention Demographic, ecological and social determinants Public health and policy aspects (including cost-effectiveness analyses).