Multisystem Injury after Wasp Stings in the Qinling Range, Shaanxi, China: Clinical Profile and Independent Predictors of Poor Outcome

Wuyang Lv^*Yaqi Ge

• Shangluo Central Hospital, Shangluo, China

Objective: This study aimed to assess the clinical characteristics and independent risk factors for adverse outcomes in multiple organ dysfunction syndrome (MODS) following wasp stings. Methods: We enrolled 187 patients admitted to the emergency department of Shangluo Central Hospital in Shaanxi Province's Qinling area between July 2023 and November 2024 and performed a 120-day survival analysis based on follow-up records. Results: The results revealed that wasp sting-MODS involves multisystem dysfunction, characterized by altered peripheral blood cell counts, acute liver/kidney/cardiac impairment, electrolyte imbalances, and coagulation abnormalities. Inflammatory and metabolic disturbances were also prominent. Glucose and lipid metabolic disorders in these patients were closely associated with altered expression of key glucose and lipid metabolism enzymes in peripheral blood leukocytes. Among these, IL-6, TNF-α, IL-10, CPT1, ACO, and GLUT1 were identified as independent predictors of hospitalization exceeding two days, with high diagnostic efficacy. Prolonged consultation time was the only independent risk factor for adverse in-hospital outcomes. Each hour of delay increased the risk of ICU admission by 40.1%, hemodialysis requirement by 31.4%, and mortality by 20.6%. Critically, patients who sought medical care within 5 hours post-sting had 8 times higher probability (95% CI: 2.3–14.5) of full recovery within 120 days after discharge compared to those with longer delays. Conclusion: Early recognition of inflammatory and metabolic biomarkers, along with medical intervention within 5 hours after a wasp sting, is essential to optimize clinical management and improve outcomes in wasp sting-MODS.