Hospital contacts after bite by the European adder (Vipera berus).
BACKGROUND
Bites by the European adder, Vipera berus, may cause significant morbidity in bite victims, but this can be reduced through adequate treatment. Since the previous Danish study, a new treatment and a severity grading has been taken into use. The aims of this study were to review clinical cases after a bite from V. berus in The North Denmark Region and to evaluate the treatment given.


METHODS
In the regional health-care database, we retrospectively identified all patients discharged with the International Classification of Diseases, 10th version (ICD-10) code "T 63.0 snake venom" in the 2007-2013 period. We reviewed patient records for patient demographics, clinical information and information about treatment.


RESULTS
During the study period, 76 patients were discharged from a hospital after being bitten by V. berus in The North Denmark Region. Envenomation grade 2 or 3 was seen in 61% of victims, and 21% of these were treated with antivenom. T-wave inversion was seen in 9% of the 54 patients in whom an electrocardiography had been performed. The median duration of admittance was 24 hours (mean 48 hours), and risk factors for a prolonged stay at the hospital were grade 2 or 3 envenomation, leukocytosis and moderate/massive oedema at the time of admittance.


CONCLUSIONS
Patients were admitted for a longer time than reported from a previous Danish study on adder bites, and many patients were possibly undertreated with regard to use of antivenom according to recommendations in recent guidelines. No adverse effects were noted due to administration of antivenom. T-wave inversion was observed more frequently than previously described.


BACKGROUND
not relevant.


BACKGROUND
The study was recorded with The North Denmark Region in accordance with a directive from the Danish Data Protection Agency.
Infektionsmedicinsk Afdeling, Klinisk Medicin, Aalborg Universitetshospital, Hobrovej 18-22, 9000 Aalborg, Denmark. bohonge@gmail.com.
Bo Langhoff
BL
Hønge
Sami Khatib
SK
Hedegaard
Stephan
S
Cederstrøm
Henrik
H
Nielsen
D000293:Adolescent; D000328:Adult; D000818:Animals; D000997:Antivenins / Q000008:administration & dosage*; D001145:Arrhythmias, Cardiac / Q000209:etiology; D002648:Child; D016208:Databases, Factual; D003718:Denmark; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012909:Snake Bites / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D017819:Viperidae; D055815:Young Adult
D000997:Antivenins