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- Title
Severe scorpion envenomation among children: does hydrocortisone improve outcome? A case-control study.
- Authors
Bahloul, Mabrouk; Chaari, Anis; Ammar, Rania; Allala, Rania; Dammak, Hassen; Turki, Olfa; Chelly, Hedi; Ben Hamida, Chokri; Bouaziz, Mounir
- Abstract
Background To analyse the efficacy and safety of systemic infusion of hydrocortisone hemisuccinate in children admitted to the intensive care unit with severe scorpion envenomation, we assessed the impact on mortality and length of hospital stay. Method We conducted a pair-wise, case-control study with 1:1 matching, reviewing records over a 13-year period (1990–2002) for the intensive care unit (ICU) of the Habib Bourguiba University Hospital, Sfax, Tunisia. A total of 184 children were included in the study (92 cases and 92 controls); cases received hydrocortisone hemisuccinate during hospitalization and controls received no steroids. Patients were matched according to age (±2 years), severity factors at admission (pulmonary edema and grades of severity of scorpion envenomation) and scorpion antivenom administration. Results Cases and controls did not differ significantly in age (4.9 ± 5.5 years vs 6.2 ± 3.8 years; p > 0.05), mean temperature on admission (37.2 ± 1.2 vs 37.2 ± 1.06; p = 0.99) or presence of systemic inflammatory response syndrome (SIRS) (77 vs 70; p = 0.198). The proportion of patients with pulmonary edema was similar in the two groups (77 vs 71; p > 0.05), and in each group 46 patients (50%) received scorpion antivenom (p > 0.05). The use of mechanical ventilation, ICU length of stay and ICU mortality was not significantly different between the studied groups. Conclusion We detected no significant difference between patients receiving steroids and steroid-free patients in terms of mortality and ICU length of stay. The hydrocortisone hemisuccinate regimen described here had a limited effect in critically ill envenomated children and, therefore, we suggest that it should not be recommended.
- Subjects
HYDROCORTISONE; TREATMENT of pulmonary edema; LENGTH of stay in hospitals; HOSPITAL admission &; discharge; ARTIFICIAL respiration; THERAPEUTICS
- Publication
Transactions of the Royal Society of Tropical Medicine & Hygiene, 2013, Vol 107, Issue 6, p349
- ISSN
0035-9203
- Publication type
Article
- DOI
10.1093/trstmh/trt028