title: Predictive Factors for Determining the Clinical Severity of Pediatric Scorpion Envenomation Cases in Southeastern Turkey.
abstract: OBJECTIVE
  The aim of this study was to define the epidemiological, clinical, and laboratory manifestations of scorpion envenomation and to identify factors that are predictive of severe cases.
  
  
  METHODS
  The medical files of 41 scorpion envenomation cases were reviewed retrospectively. The cases were classified as mild-moderate or severe. The epidemiological, clinical, and laboratory findings of patients were recorded.
  
  
  RESULTS
  There were 27 patients (65.9%) in the mild-moderate group and 14 patients (34.1%) in the severe group. The median age of all patients was 48 months. The most common systemic finding was cold extremities (41.5%). In all patients, the most commonly observed dysrhythmia was sinus tachycardia (34.1%). Two patients (4.9%) had pulseless ventricular tachycardia and died. Pulmonary edema and myocarditis were observed in 9 patients (22%). Median values of leukocyte and glucose levels were markedly increased in the severe group. Additionally, the mean thrombocyte level (540,857 ± 115,261 cells/mm(3)) in the severe group was significantly increased compared with the mild-moderate group (391,365 ± 150,017 cells/mm(3)). Thrombocyte levels exhibited a positive correlation with leukocyte and glucose values and a negative correlation with patient left ventricular ejection fraction. Multivariate analysis of laboratory parameters indicated that the most predictive factor for clinical severity is thrombocytosis (odds ratio 23.9; 95% CI: 1.6-353.5, P = .021).
  
  
  CONCLUSIONS
  Although our results share some similarities with those of other reports, thrombocytosis was markedly increased in the severe group and served as the most predictive laboratory factor of clinical severity.
authors.affiliation: Department of Pediatric Emergency Care, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey (Drs Çağlar and Duman).
authors.forename: Aykut
authors.initials: A
authors.lastname: Çağlar
authors.affiliation: Department of Pediatric Emergency Care, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey (Drs Çağlar and Duman).
authors.forename: Halil
authors.initials: H
authors.lastname: Köse
authors.affiliation: Department of Pediatrics, Şanlıurfa Children's Hospital, Şanlıurfa, Turkey (Drs Babayiğit and Köse).
authors.forename: Aslan
authors.initials: A
authors.lastname: Babayiğit
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Şanlıurfa Children's Hospital, Şanlıurfa, Turkey (Dr Öner).
authors.forename: Taliha
authors.initials: T
authors.lastname: Öner
authors.affiliation: Department of Pediatric Emergency Care, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey (Drs Çağlar and Duman). Electronic address: mduman@deu.edu.tr.
authors.forename: Murat
authors.initials: M
authors.lastname: Duman
mesh_terms: D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D065008:Scorpion Stings / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D012604:Scorpion Venoms / Q000506:poisoning; D012605:Scorpions; D012720:Severity of Illness Index; D013922:Thrombocytosis / Q000209:etiology; D014421:Turkey / Q000453:epidemiology
chemical_list: D000997:Antivenins; D012604:Scorpion Venoms
keywords: critical care; pediatric; scorpion; thrombocytosis; ventricular tachycardia