Epidemiological characterization of ophidian accidents in a Colombian tertiary referral hospital. Retrospective study 2004-2014

Abstract

Introduction: In Colombia, there are 5 000 cases of ophidism per year. This is a public health issue that causes mortality in 8% of cases and disability in 10% due to inadequate clinical attention. Objective: To describe the clinical and epidemiological characteristics of patients diagnosed with ophidic accident in a tertiary hospital in Colombia. Materials and methods: A review of clinical charts that included a diagnosis of ophidism during the 2004-2014 period was made at Hospital Universitario de La Samaritana Empresa Social del Estado. The frequency of the variables associated with snake bites, previous treatment and in-hospital management was analyzed. Results: 42 medical charts were reviewed. Ophidism predominated in male farmers, who presented with bites in the lower limbs and were initially treated by medicine men/women. 90% of patients developed superinfections, 30% wound culture, 74% received antibiotics, 50% underwent fasciotomy and 95.2% were given antivenin. Conclusions: Significant variability in the management of patients, discrepancy in antivenin dose and in classification of poisoning severity were observed throughout the study, as well as a high incidence of infections despite antibiotic schemes and surgical procedures. Medical management of ophidic accidents must be continuously updated to reduce disability and mortality in patients.