Evidence map›Paper›PMID 31482319›Full record

Trial reportJournal of medical toxicology : official journal of the American College of Medical Toxicology2020

Recovery from Copperhead Snake Envenomation: Role of Age, Sex, Bite Location, Severity, and Treatment.

Eric J Lavonas, Randy I Burnham, John Schwarz, Eugenia Quackenbush, Brandon Lewis, S Rutherfoord Rose, Spencer Greene, Eric A Toschlog, Nathan P Charlton, Michael E Mullins and 8 more

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 7 citations in OpenAlex.

  1. Snake Bite Management: A Scoping Review of the Literature.Plastic and reconstructive surgery. Global open · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 13 institutions in 1 country.

Eric J LavonasRocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA. eric.lavonas@dhha.org.ORCID 0000-0002-5891-1451
Randy I BurnhamRocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA.
John SchwarzRocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA.
Eugenia QuackenbushDepartment of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Brandon LewisTexas A&M Health Science Center, College Station, TX, USA.
S Rutherfoord RoseDepartment of Emergency Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Spencer GreeneHenry J. N. Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA.
Eric A ToschlogDepartment of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC, USA.
Nathan P CharltonDivision of Medical Toxicology, University of Virginia, Charlottesville, VA, USA.
Michael E MullinsDivision of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Richard SchwartzDepartment of Emergency Medicine and Hospital Services, Medical College of Georgia, Augusta, GA, USA.
David DenningDepartment of Surgery, Marshall Health, Huntington, WV, USA.
Kapil SharmaDepartment of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Kurt KleinschmidtDepartment of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Sean P BushDepartment of Emergency Medicine, Brody School of Medicine at East Carolina University, Greenville, NC, USA.
Victoria E AndersonRocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA.
Adit A GindeDepartment of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Charles J GerardoDivision of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, USA.
Denver Health Medical Center · USEast Carolina University · USThe University of Texas Southwestern Medical Center · USAugusta University · USBaylor College of Medicine · USDuke University · USMarshall Health · USTexas A&M Health Science Center · USUniversity of Colorado Denver · USUniversity of North Carolina at Chapel Hill · USUniversity of Virginia · USVirginia Commonwealth University · USWashington University in St. Louis · US

Funding

NIH Prior Approval Process ProfessionalUL1TR002535 · NCATS · UNIVERSITY OF COLORADO DENVER · PI SOKOL, RONALD J. · 2018 to 2022
$51.1M
NCATS NIH HHS UL1 TR002535
6 · The paper itself

Abstract

introductionFew data exist to understand the recovery phase of pit viper envenomation. A recently published placebo-controlled clinical trial affords this opportunity. The purpose of this study is to examine the time course of recovery from copperhead snake (Agkistrodon contortrix) envenomation patients managed with and without the use of antivenom, stratified by age, sex, anatomic site of envenomation, initial severity of envenomation, and geographic region.

methodsThis is a post-hoc subgroup analysis of data from a multi-center double-blinded clinical trial of Fab antivenom (FabAV) vs. placebo. Outcomes were the Patient-Specific Functional Scale (PSFS) score at 3, 7, 10, and 14 days after envenomation. Least-squares mean PSFS score curves were calculated for each subgroup, and repeated measures ANOVA was used to estimate between-group comparisons.

resultsSeventy-two subjects were included, of whom 44 received FabAV. Males demonstrated better overall recovery than females (model predicted PSFS score 6.18 vs 4.99; difference 1.19; 95% CI 0.12 to 2.25; p = 0.029). No sex difference was found in response to FabAV. Overall recovery and effect of FabAV were similar in adult vs adolescent patients, patients with upper vs lower extremity envenomation, and patients with initially mild vs moderate envenomation signs. Analysis by geographic location was not successful due to ANOVA mode instability.

conclusionsMale victims of copperhead snake envenomation demonstrate slightly better recovery than females, but response to Fab antivenom overall is similar across all subgroups studied.

Indexed as

AgkistrodonAdultAge FactorsAnimalsAntiveninsCrotalid VenomsDouble-Blind MethodFemaleHumansImmunoglobulin Fab FragmentsMaleMiddle AgedRecovery of FunctionSeverity of Illness IndexSex FactorsSnake BitesAntiveninsCrotalidae Polyvalent immune FabCrotalid VenomsImmunoglobulin Fab FragmentsAgkistrodonAntiveninsCopperheadEnvenomationFabSnake

Identifiers

PMID31482319
PMCPMC6942102
OpenAlexW2971831688

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.