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Revista de la Facultad de Medicina Humana

Print version ISSN 1814-5469On-line version ISSN 2308-0531

Abstract

PICHARDO-RODRIGUEZ, Rafael; SAAVEDRA-VELASCO, Marcos; ASCARZA-SALDANA, Jhonatan  and  NAQUIRA-VELARDE, Cesar. PREPARATION AND VALIDATION OF A SYSTEMIC LOXOSCELISM PREDICTION PROTOCOL. Rev. Fac. Med. Hum. [online]. 2020, vol.20, n.1, pp.32-42. ISSN 1814-5469.  http://dx.doi.org/10.25176/rfmh.v20i1.2642.

Introduction:

Systemic loxoscelism is the most severe complication of loxoscelism. The management of the cadre by health personnel presents a high variability due to factors that are currently unknown. There is no standard of reference or a clinical prediction model that can guide our decisions when approaching a spider bite patient.

Objective:

Develop and validate a clinical prediction rule for systemic loxoscelism.

Methods:

An observational study of derivation and validation of a clinical prediction model was carried out with diagnostic test validation based on a historical single-arm cohort in patients treated at Vitarte Hospital between 2007 and 2016 and international clinical reports published.

Results:

Systemic loxoscelism occurred only in 32.9% (n = 24) of cases. For the bivariate analysis, the variables that showed a statistically significant association (P <0.05) were sex, bite in an independent abdomen in relation to other parts of the body, bite in other parts of the body than the abdomen, vomiting , fever and hemoglobinuria. The regression analysis included in the analysis the variables: sex, vomit, fever and hemoglobinuria. Bootstrapping determined the internal validity of the model. The area under the curve was 0.91 (P <0.05) and the sensitivity, specificity, LR + and LR- were 79.1%, 93.8%, 12.9 and 0.22 respectively.

Conclusions:

The protocol of prediction of systemic derived loxoscelism is valid, for the moment.

Keywords : Spider venoms; Brown recluse spider; Prediction.

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