Comparison of Clinical Manifestations, Treatments, and Outcomes between Vespidae Sting and Formicidae Sting Patients in the Emergency Department in Taiwan

Yen-Yue Lin, Chih-Chien Chiu, Hsin-An Chang, Yung-Hsi Kao, Po-Jen Hsiao and Chih-Pin Chuu
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Yen-Yue Lin: Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan City 325, Taiwan
Chih-Chien Chiu: Division of Infectious Disease and Tropical Medicine, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan City 325, Taiwan
Hsin-An Chang: Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Yung-Hsi Kao: Department of Life Sciences, National Central University, Taoyuan City 320, Taiwan
Po-Jen Hsiao: Department of Life Sciences, National Central University, Taoyuan City 320, Taiwan
Chih-Pin Chuu: Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli County 350, Taiwan

IJERPH, 2020, vol. 17, issue 17, 1-16

Abstract: Background: Hymenopteran stings are the most common animal insult injury encountered in the emergency department. With increasing global spread of imported fire ants in recent decades, the rate of Formicidae assault has become a serious problem in many countries. Formicidae-associated injuries gradually increased in Taiwan in recent decades and became the second most common arthropod assault injury in our ED. The present study aimed at comparing the clinical characteristics of Formicidae sting patients with those of the most serious and common group, Vespidae sting patients, in an emergency department (ED) in Taiwan. Methods: This retrospective study included patients who were admitted between 2015 to 2018 to the ED in a local teaching hospital in Taiwan after a Vespidae or Formicidae sting. Cases with anaphylactic reaction were further compared. Results: We reviewed the records of 881 subjects (503 males, 378 females; mean age, 49.09 ± 17.62 years) who visited our emergency department due to Vespidae or Formicidae stings. A total of 538 (61.1%) were categorized into the Vespidae group, and 343 (38.9%) were sorted into the Formicidae group. The Formicidae group had a longer ED length of stay (79.15 ± 92.30 vs. 108.00 ± 96.50 min, p < 0.01), but the Vespidae group had more cases that required hospitalization (1.9% vs. 0.3%, p = 0.04). Antihistamines (76.8% vs. 80.2%, p < 0.01) were more frequently used in the Formicidae group, while analgesics were more frequently used in the Vespidae group (38.1% vs. 12.5%, p < 0.01). The Vespidae group had more local reactions, and the Formicidae group had more extreme, systemic, or anaphylactic allergic reactions. Creatine kinase was significantly higher in the Vespidae group with an anaphylactic reaction. Sting frequency in both groups exhibited the same positive associations with average temperature of the month and weekend days. Conclusion: Formicidae sting patients presented to the ED with higher rate allergic reactions and spent more time in the ED than Vespidae sting patients. However, Vespidae sting patients had more complications and higher rates of admission, especially with anaphylactic reaction. Laboratory data, especially creatine kinase data, were more valuable to check in Vespidae sting patients with an anaphylactic reaction in the ED. Both groups exhibited positive correlations with temperature and a higher rate on weekend days.

Keywords: anaphylaxis; Vespidae; Formicidae; hymenoptera; emergency department (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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