{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:46:35Z","timestamp":1791740795670,"version":"4.3.4"},"reference-count":8,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Venomous snakebites require timely antivenom administration to prevent progression of local and systemic toxicity. In the United States, two FDA-approved crotalid antivenoms, CroFab\u00ae and ANAVIP\u00ae, are available, both associated with substantial cost. Real-world data comparing antivenom utilization and institutional cost between these agents remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed an IRB-approved retrospective review of consecutive patients treated with antivenom for venomous snakebite and admitted to a Level I trauma center between March 2017 and August 2023. Demographics, snakebite characteristics, Snakebite Severity Score (SSS), clinical outcomes, complications, hospital length of stay (LOS), and antivenom-associated costs were abstracted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty-four patients were admitted for venomous snakebite and received antivenom; 48 received a single antivenom formulation. CroFab\u00ae was administered to 36 patients (75%) and ANAVIP\u00ae to 12 patients (25%). There were no significant differences between groups in demographic characteristics or injury severity. Clinical outcomes, including improvement after initial antivenom administration, need for additional dosing, antivenom-related complications, and hospital LOS, were comparable between groups. Median hospital cost was significantly lower in the ANAVIP\u00ae group compared with CroFab\u00ae ($9665.30 [IQR $9665.30\u2013$9670.00] vs $16,470.57 [IQR $11,775.04\u2013$27,184.72],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this single-center trauma cohort, ANAVIP\u00ae and CroFab\u00ae demonstrated comparable clinical effectiveness for the treatment of crotalid snakebites. Use of ANAVIP\u00ae was associated with a substantial reduction in hospital cost without detectable compromise in clinical outcomes. These findings support consideration of ANAVIP\u00ae as a cost-conscious antivenom strategy in trauma systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261492221","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:42:01Z","timestamp":1791481321000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Choosing Value: Antivenom Selection in the Modern Trauma System"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0027-1664","authenticated-orcid":false,"given":"Jack H.","family":"Bowdle","sequence":"first","affiliation":[{"name":"University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Butler","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Science Center College of Medicine, Knoxville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Pritchett","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drew","family":"Hungerford","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"King","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Science Center College of Medicine, Knoxville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda L.","family":"McKinney","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Science Center College of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Heidel","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Science Center College of Medicine, Knoxville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lou M.","family":"Smith","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Science Center College of Medicine, Knoxville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1552-024X","authenticated-orcid":false,"given":"Catherine L.","family":"McKnight","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Science Center College of Medicine, Knoxville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-227X-11-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.161.16.2030"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2014.988320"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13181-017-0638-0"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2023.06.019"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13181-023-00920-5"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.100207"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(97)70123-4"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261492221","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261492221","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261492221","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:11:52Z","timestamp":1791738712000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261492221"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":8,"alternative-id":["10.1177\/00031348261492221"],"URL":"https:\/\/doi.org\/10.1177\/00031348261492221","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]},"article-number":"00031348261492221"}}