Prognostic value of red blood cell width distribution-to-platelet ratio in patients with snakebite-associated multiple organ dysfunction syndrome：A retrospective observational study 

Abstract

Background: Snakebite-induced organ dysfunction emerging as the primary determinant of morbidity and mortality. This study aims to evaluate the prognostic relevance of multiple organ dysfunction syndrome (MODS) after snakebites. Methods: A retrospective study included 637 patients with snakebite between 2015 and 2020 from two hospitals in Anhui province, China. Data were collected at two time points: on the 1st-day and the 5th-day after treatment. All patients were divided into two groups according to the presence or absence of MODS. T-tests, chi-square tests, and univariate and multivariate logistical analyses were used to identify the prognostic factors for the development of MODS. Results: 56 (8.8%) patients developed MODS following snakebite. Logistics analyses indicated that from being bitten at the hospital, the 1st-day of red blood cell distribution width-to-platelet ratio (RPR) and creatinine (CR) levels, and the 5th-day of aspartate aminotransferase (AST) were significantly associated with the development of MODS. The sensitivity and the specificity of the 1st-day RPR were calculated by the received operating characteristic curve (AUC=0.720, 95%CI, 0.642-0.798). The 1st day RPR=0.110 and the 5th day RPR=0.085. Conclusion: The 1st-day RPR ＞0.110 is prone to be a new independent predictive factor for the development of MODS after snakebite.