PREPARATION and VALIDATION of A SYSTEMIC LOXOSCELISM PREDICTION PROTOCOL

Pichardo-Rodriguez R.; Saavedra-Velasco M.; Ascarza-Saldaña J.; Naquira-Velarde C. · Revista de la Facultad de Medicina Humana (2020) · DOI: 10.25176/rfmh.v20i1.2642

Resumen

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. Conclusion: The protocol of prediction of systemic derived loxoscelism is valid, for the moment. Copyright Mishina ES et al.

Instituciones: Universidad Ricardo Palma