@entity4854 is a risk factor for high-grade envenomations after European viper bites (Vipera spp.) in XXXX .

@entity1 @entity158 @entity4854 @entity413 @entity5900
CONTEXT: @entity4854 has been described in severe scorpion @entity5900 , we wanted to analyze if it was applicable to viper bites in @entity1 . AIM: To describe clinical, biological, and therapeutic characteristics of 83 @entity1 bitten by European viper (Vipera spp.) and to confirm that @entity4854 is a risk factor for high-grade @entity5900 . MATERIAL AND METHODS: A retrospective study was conducted between 2001 and 2014 in the pediatric emergency department of a tertiary level @entity1 's hospital. Collected data were: age and sex of @entity1 ; day and time of admission; day, time and circumstances of the accident; snake identification; bite location; @entity5900 severity; presence of fang marks; prehospital care; laboratory abnormalities, use of specific immunotherapy, associated treatments; length of stay; hospital course. RESULTS: Eighty-three @entity1 were included (62 @entity1 , 21 @entity1 ). The mean age was 7.4        3.9 years. Bites were most often located on the lower extremities (66%). The classification of @entity5900 was: 83% low grade (absent or minor @entity5900 ) and 17% high grade (moderate to severe @entity5900 ). All high-grade envenomations received specific immunotherapy (Viperfav(TM), (Aventis Pasteur, MSD, Lyon, France). Being bitten on an upper extremity (odds ratio [OR] 51.1 95% class interval [CI] [6.1-424], p   <   0.0001), during the afternoon (OR 13.4 95% CI [1.7-107.9], p   =   0.015), feeling @entity158 (OR 4.2 95% CI [1.1-16.5], p   =   0.023), and high initial plasma @entity413 level (6.5        1.7   mmol/L versus 5.0        0.9   mmol/L, p   =   0.027) were associated with a significant risk of high-grade @entity5900 . CONCLUSION: We have confirmed a potential link between initial @entity4854 and the risk of progression to high-grade @entity5900 as well as its association with other published predictive factors.
