Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Akrep Sokması Vakalarında Prognozu Öngören Belirteçler: Üçüncü Basamak Çocuk Acil Servis Kesitsel Çalışması
Predictors of Prognosis in Scorpion Sting Cases: Cross-sectional Study of the Third Care Pediatric Emergency Service
Alper ÇİÇEKa, Gülşah DEMİRa, Pelin ELİBOLa, Şefika BARDAKa, Gamze GÖKALPb, Tuğçe NALBANTa, Bahri AŞCIc, Emel BERKSOYa
aSağlık Bilimleri Üniversitesi, Tepecik Eğitim ve Araştırma Hastanesi, Çocuk Acil Tıp ABD, İzmir, TÜRKİYE
bİzmir Kâtip Çelebi Üniversitesi, Tepecik Eğitim ve Araştırma Hastanesi, Çocuk Acil BD, İzmir, TÜRKİYE
cTepecik Eğitim ve Araştırma Hastanesi, Çocuk Sağlığı ve Hastalıkları Kliniği, İzmir, TÜRKİYE
Turkiye Klinikleri J Pediatr. 2021;30(3):177-83
doi: 10.5336/pediatr.2021-82083
Article Language: TR
Full Text
ÖZET
 Amaç: Çalışmamızda, akrep sokması nedeniyle başvuran çocukların klinik bulgularını ve laboratuvar sonuçlarını değerlendirmek, hastaların tedaviye yanıtlarını, prognozlarını belirlemek ve ileri evre vakaları öngörmede kullanılacak belirteçleri saptamak amaçlandı. Gereç ve Yöntemler: Ocak 2008 ve Kasım 2020 tarihleri arasında Sağlık Bilimleri Üniversitesi Tepecik Eğitim ve Araştırma Hastanesi çocuk acil servisine akrep sokması nedeniyle başvuran hastaların epidemiyolojik, klinik, laboratuvar özellikleriyle tedavi ve prognozları geriye dönük olarak dosya verilerinden incelendi. Bulgular: Akrep sokması nedeniyle acil servisimize başvuran toplam 77 hastanın ortalama yaşı 82,3±57,3 ay idi. Başvuran hastaların 60'ının (%77,9) klinik derecelendirmesi Evre I, 12'si (%15,6) Evre II, 4'ü (%5,2) Evre III ve 1'i (%1,3) Evre IV olarak saptandı. Evrelemeye göre karşılaştırma yapıldığında Evre I hastaların kreatinin kinaz [creatinine kinase (CK)] ortalaması 175,7±78,8 U/L, nötrofil sayı ortalaması 5,9±3,3 x103/uL, serum amilaz değer ortalaması 69,3±42,2 U/L olup; Evre II-III-IV hastaların ise CK ortalaması 360±309,3 U/L, nötrofil sayı ortalaması 9,9±4,6 x103/uL, serum amilaz ortalaması 113,6±81,2 U/L olarak saptandı (p<0,05). Laboratuvar değerleri yatan-ayaktan taburcu ve antivenom verilen-verilmeyen hastalarda da karşılaştırıldı ve aynı parametreler anlamlı yüksek bulundu (p<0,05). Sonuç: Akrep sokması vakalarında hastaların klinik olarak kötüye gidebileceği her zaman akılda tutulmalıdır. Serum CK, nötrofil sayısı ve amilaz değerleri hastalarda klinik prognozu belirlemede etkili olabilir.

Anahtar Kelimeler: Acil servis; akrep sokması; çocuk
ABSTRACT
 Objective: It was aimed to determine the clinical appearance, laboratory results, treatment, and prognosis of children presenting with scorpion sting and aims to determine the predictive markers in cases of advanced stages. Material and Methods: The patients who were admitted to the Pediatric Emergency Clinic of Health Sciences University Tepecik Education and Research Hospital between January 2008 and November 2020 with a complaint of scorpion sting were analyzed retrospectively in terms of epidemiological features, clinical appearance, laboratory results, treatment methods, and prognosis. Results: The mean age of 77 patients who were admitted to our emergency department due to scorpion stings was 82.3±57.3 months. The clinical grade of 60 patients (77.9%) who were admitted was Stage I, 12 (15.6%) of them was Stage II, 4 (5.2%) was Stage III, and one (1.3%) was detected as Stage IV. When compared according to staging, the mean creatinine kinase (CK) of patients with stage I was 175.7±78.8 U/L, mean neutrophil count was 5.9±3.3 x103/uL, mean serum amylase value is 69.3'±42.2 U/L; in patients with Stage II-IIIIV, mean CK level was 360±309.3 U/L, mean neutrophil count was 9.9±4.6 x103/uL, mean serum amylase level was 113.6±81.2 U/L (p<0.05). When laboratory values were compared between inpatientoutpatient discharge and antivenom given and not given patients, the same parameters were found to be significantly higher (p<0.05). Conclusion: It should always be kept in mind that patients with scorpion sting may deteriorate clinically. Serum CK levels, neutrophil count, and amylase levels may be used effectively in determining clinical prognosis in patients with scorpion sting.

Keywords: Emergency service; scorpion sting; child
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