Title: Evaluation of Outcome Determinants in Snakebite Victims in A Rural Medical College of South Bengal
Authors: Gantait Kripasindhu, Gantait Ishita, Som Kunal
DOI: https://dx.doi.org/10.18535/jmscr/v4i12.60
Abstract
Background: Snake bite is a neglected public health problem in India. Hence, identification of the clinical parameters as reliable determinants of mortality which may be used at peripheral levels of health care, is essential.
Methods: Hospital records of 232 patients (165 males and 67 females) with age ranging from 12 to 80 years, admitted to Midnapore Medical College in south Bengal during January 2015 to December 2015 were reviewed retrospectively.
Results: 98% snakebites were on extremities; more in legs (67%) than hands (31%). Most (53.5%) bites occurred in the morning (4 am to noon). Mean (SD) time for bite-to-hospital and bite-to-injection of anti-snake venom (ASV) was 144.6 (77.6) and 169 (182.8) minutes respectively. Twenty seven cases (11.9%)had died. Case fatality ratio (CFR)was significantly higher in89 patients with un-clotted blood as compared to 143 patients with clotted blood (25.9% vs 1.8%, p<0.0005). Significantly higher CFR was observed in 112 patients who received ASV in >2 hours after the bite compared to 120 cases who received ASV within two hours (8.9% vs 0.9%, p <0.0001). Odds ratio of fatality were higher among those who had urine output of<400ml in the first 24hours (OR 26.4).
Conclusions: Clinical indicators could be used by healthcare providers for referral to identify snake bite patients who may have fatal outcome.
Keywords: Snakebite, urine output, anti-snake venom, outcome, determinants, Bengal.
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