To explore the clinically relevant factors affecting the severity of wasp sting.

A total of 73 wasp sting patients admitted to the Department of Emergency Medicine of the First Affiliated Hospital of Wannan Medical College from January 2016 to August 2020 were retrospectively analyzed. According to the change of sequential organ failure assessment during hospitalization (ΔSOFA), patients were divided into a ΔSOFA score ≥ 2 group(n= 33) and a ΔSOFA score < 2 group (n= 40). The general data, clinical symptoms, laboratory indicators and prognosis were compared between the two groups. A multi-factor Logistic regression model was used to analyze factors affecting the severity of wasp sting. A receiver operating characteristic (ROC) curve was used to analyze their predictive value.

The age [(62 ± 12) years vs. (44 ± 20) years, t= 4.563, P < 0.001], stinging wasp species (χ²= 33.277, P < 0.001), gross hematuria (19/33 vs. 1/40, χ²= 24.875, P < 0.001), rash (6/33 vs. 17/40, χ²= 4.995, P= 0.026), creatine kinase [4 297 (1 427, 11 871) U/L vs. 180 (124, 405) U/L, H= 5.012, P < 0.001], total bilirubin [46 (26, 124) μmol/L vs. 11 (8, 17) μmol/L, H= 6.140, P < 0.001], erythrocyte count [(3.6 ± 0.9) × 10¹²/L vs. (4.4 ± 0.8) × 10¹²/L, t= 3.967, P < 0.001], platelet count [(151 ± 70) × 10⁹/L vs. (203 ± 72) × 10⁹/L, t= 3.141, P= 0.002], leukocyte count [(19 ± 8) × 10⁹/L vs. (13 ± 5) × 10⁹/L, t= 3.431, P= 0.001], creatinine [126 (78, 261) μmol/L vs. 64 (52, 75) μmol/L, H= 4.805, P < 0.001], cystatin C [1.5 (1.0, 2.1) mg/L vs. 0.9 (0.8, 1.1) mg/L, H= 4.753, P < 0.001] and activated partial thromboplastin time [44.8 (26.9, 81.9) s vs. 26.1 (22.9, 29.5) s, H= 3.668, P < 0.001] all showed significant differences between the ΔSOFA score ≥ 2 group and the ΔSOFA score < 2 group. Multi-factor Logistic regression analysis showed that stinging wasp species [odds ratio (OR)= 83.532, 95% confidence interval (CI) (1.516, 4 601.326), P= 0.031] and total bilirubin [OR= 1.092, 95%CI (1.003, 1.190), P= 0.043)] were independent factors affecting the ΔSOFA after wasp sting. ROC curve analysis showed that stinging wasp species [area under the curve (AUC)= 0.839, 95%CI (0.738, 0.940), P < 0.001] and total bilirubin [AUC= 0.920, 95%CI (0.859, 0.980), P < 0.001] had predictive value for the severity of wasp sting. The hospitalization stay of patients in the ΔSOFA score ≥ 2 group was significantly higher than that of the ΔSOFA score < 2 group [11.0 (4.0, 24.5) d vs. 2.5 (2.0, 3.0) d, H= 5.056, P < 0.001].

Stinging wasp species and total bilirubin have predictive value for the severity of wasp sting, and their early identification can help assess the severity and conduct timely clinical intervention for patients.