Clinical predictors of in‐hospital mortality in patients with snake bite: a retrospective study from a rural hospital in central India

Kalantri, Shriprakash; Singh, Amandeep; Joshi, Rajnish; Malamba, Samuel; Ho, Christine; Ezoua, Joseph; Morgan, Maureen

doi:10.1111/j.1365-3156.2005.01535.x

Cited by 66 publications

(71 citation statements)

References 23 publications

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“…The predominance of male victims suggests a special risk of outdoor activity. This is comparable to the studies done by other authors [4,[11][12][13][14].…”

Section: Sex and Educationsupporting

confidence: 82%

“…Rural inhabitants form the biggest chunk of casualties (67.5%) attributed to the labour they are generally engaged in and this collaborates with inference drawn from other studies [4,[9][10][11][12][13].…”

Section: Rural Areasupporting

confidence: 68%

“…Similar observation was also made by other authors [11,18,19]. The location of hospital and the means of transportation serve as the main limiting factor apart from the usual treatment from quacks for delay in arrival at hospital.…”

Section: Interval Between Time Of Bite and Hospital Admissionsupporting

confidence: 65%

“…Bites on the head and trunk mostly occur when nocturnal species bite people while sleeping [19]. Lower extremity as the most common site for snake bite has been observed in similar other studies [9,11,14,19,20].…”

Section: Body Regionmentioning

confidence: 70%

“…48.5% of snakebites occurred in agriculture industry and farming activities, [4,[9][10][11][12] attributed to unshod farmers which makes them prone to the risk [4,9].…”

Section: Agricultural Activitymentioning

confidence: 99%

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Epidemiological Profile of Snake Bite at Tertiary Care Hospital, North India

Anjum¹,

Husain²,

Hanif³

et al. 2012

J Forensic Res

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This hospital based prospective study was conducted from September 2009 to September 2011.All the patients irrespective of age and sex, who reported with history of snake bite were included in the study. A total 169 snake bite patients, consisting of 116 (68.7%) male and 53 (31.3%) female [mean (SD) age 32±12 years] were admitted to the hospital during the study period, the ratio being 2.2:1. The majority of victims belonged to rural areas (67.5%) and most vulnerable occupation group was the people involved in agricultural activities (48.5%). The study population was predominately bitten outdoors (62.7%). Most of the time people could not identify the snake (52.1%) and among identified poisonous snakes Elapidae and Viperidae type were 15.4% and 13.0% respectively. The maximum cases of snakebite were recorded in the 3rd quarter of the year (67.4%) and peak incidence of snake bite was recorded in the time between 6:00 PM to 12:00 midnight (30.2%). In 69.2% of cases, the site of snake bite was lower limbs. The commonest manifestation was fright (85.2%) followed by pain at local site (57.9%). Majority of the victims were treated with ASV (81.1%) and most of them survived (92%).

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“…The predominance of male victims suggests a special risk of outdoor activity. This is comparable to the studies done by other authors [4,[11][12][13][14].…”

Section: Sex and Educationsupporting

confidence: 82%

Section: Rural Areasupporting

confidence: 68%

Section: Interval Between Time Of Bite and Hospital Admissionsupporting

confidence: 65%

Section: Body Regionmentioning

confidence: 70%

“…48.5% of snakebites occurred in agriculture industry and farming activities, [4,[9][10][11][12] attributed to unshod farmers which makes them prone to the risk [4,9].…”

Section: Agricultural Activitymentioning

confidence: 99%

See 3 more Smart Citations

Epidemiological Profile of Snake Bite at Tertiary Care Hospital, North India

Anjum¹,

Husain²,

Hanif³

et al. 2012

J Forensic Res

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Surgery in management of snake envenomation in children

et al. 2011

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Mortality Predictors of Snake Bite Envenomation in Southern India—A Ten-Year Retrospective Audit of 533 Patients

David¹,

Matathia²,

Christopher³

2012

J. Med. Toxicol.

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Snake bite incidence is highest in Asia and sub-Saharan Africa. This retrospective audit of 533 adult patients, who had presented to the Emergency Department, collates clinical features, effect of pharmacologic interventions and the risk factors that influence morbidity and mortality. Dual toxicity, neurological and haematological, was observed in 30.4% of patients. Laboratory evidence of haematotoxicity was demonstrated in 314 (58.9%) and 40% demonstrated clinical evidence of bleeding. However, 7.3% of these patients did not have laboratory evidence of bleeding disorder (p < 0.001). Conversely, 60% did not have clinical evidence of bleeding, but demonstrated laboratory evidence of abnormal parameters. Acute kidney injury (AKI) was evident in 28% of patients and 15.3% required haemodialysis. About 25% with no haematotoxicity showed evidence of AKI. The majority received 6-12 vials of poly-valent anti-snake venom. Hypersensitivity reaction rate was 8% and predominantly anaphylactoid in nature. The length of hospital stay ranged from 2 to 28 days and 20% required mechanical ventilation. Overall mortality rate was 7.5% with significant association to AKI, haematotoxicity and assisted ventilation. The mortality rate was 18% in patients with pre-hospital delay more than 24 h, as against 5% when admitted within the above specified period (p = <0.001). The strength of this study is the accrued information of over a period of 10 years of snake-bite management through the Emergency Department of a university hospital setting. The limitations are the retrospective study design and the rejection percentage of 15.5% due to insufficient information from the total chart pool.

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Clinical predictors of in‐hospital mortality in patients with snake bite: a retrospective study from a rural hospital in central India

Cited by 66 publications

References 23 publications

Epidemiological Profile of Snake Bite at Tertiary Care Hospital, North India

Epidemiological Profile of Snake Bite at Tertiary Care Hospital, North India

Surgery in management of snake envenomation in children

Mortality Predictors of Snake Bite Envenomation in Southern India—A Ten-Year Retrospective Audit of 533 Patients

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