title: Predictors of the development of post-snakebite compartment syndrome.
abstract: BACKGROUND
  To identify the factors associated with the development of post-snakebite compartment syndrome (PSCS) in snakebite patients and to analyze the clinical prognosis of these patients.
  
  
  METHODS
  We retrospectively reviewed the medical records of patients who presented to our institution with snakebites from March 2009 to December 2012. The clinical data, hospital course and outcome were all recorded.
  
  
  RESULTS
  A total of 136 patients were included in the present study. Nine patients developed PSCS and underwent fasciotomy. Relative to the non-PSCS group, the PSCS group demonstrated a significant increase in the white blood cell count (WBC, p = 0.006), segment form (Seg, p ≤ 0.001), aspartate aminotransferase level (AST, p = 0.002) and alanine aminotransferase level (ALT, p = 0.008). Elevated WBC count and AST level were identified as independent risk factors for PSCS (p = 0.028 and 0.037, respectively) in a multivariate analysis.
  
  
  CONCLUSIONS
  Snakebite patients have a high likelihood of developing locoregional complications such as PSCS. Symptomatic snakebite patients should be observed for at least 48 h, and increased WBC counts and AST levels are risk factors for PSCS.
authors.affiliation: Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan.
authors.forename: Chih-Po
authors.initials: CP
authors.lastname: Hsu
authors.affiliation: Department of Trauma and Emergency Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Jung-Fang
authors.initials: JF
authors.lastname: Chuang
authors.affiliation: Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan.
authors.forename: Yu-Pao
authors.initials: YP
authors.lastname: Hsu
authors.affiliation: Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan.
authors.forename: Shang-Yu
authors.initials: SY
authors.lastname: Wang
authors.affiliation: Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan.
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Fu
authors.affiliation: Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan.
authors.forename: Kuo-Ching
authors.initials: KC
authors.lastname: Yuan
authors.affiliation: Division of Trauma Plastic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chih-Hao
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan.
authors.forename: Shih-Ching
authors.initials: SC
authors.lastname: Kang
authors.affiliation: Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan. Surgymet@gmail.com.
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Liao
mesh_terms: D000328:Adult; D000368:Aged; D000997:Antivenins / Q000008:administration & dosage; D015331:Cohort Studies; D003161:Compartment Syndromes / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012909:Snake Bites / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D012910:Snake Venoms / Q000097:blood; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D000997:Antivenins; D012910:Snake Venoms