Status of administration of anti-viper venom serum in Japan：Secondary analysis of the OROCHI study

Abstract

The OROCHI study, a multicenter prospective observational study on viper snakebites, could not sufficiently demonstrate the effectiveness of anti-viper venom serum.In the present study, we conducted a secondary analysis of this study to identify factors influencing the administration of anti-viper venom serum during the observational period between April 2020 and October 2022. A total of 106 cases in the OROCHI study were analyzed, including 59 and 47 patients with and without administration of anti-viper venom serum, respectively. The grade of the viper bite on hospital admission was identified as a significant factor (univariate：p＝0.001; multivariate：p＝0.019; adjusted odds ratio：2.000). Receiver operating characteristic analysis identified a cutoff value of >1 for the viper bite grade on admission, with a sensitivity of 86.4％ and a specificity of 40.4％. These findings suggest, in Japan, a viper bite grade on admission is a key determinant for the administration of anti-viper venom serum.