Introduction:
Vasculotoxic Snakebite is an occupational hazard in India. Despite improvement in management of SB there is high mortality rate. Along with there is marked progression of snakebite associated AKI (SAKI) to CKD is high. The purpose of this study is to explore the clinical profiles and outcomes of snakebite envenomation in a tertiary care Hospital.
Methods:
It is a descriptive, cohort, longitudinal, prospective study. The patients were admitted in General Medicine Department of Nil Ratan Sircar Medical College and Hospital, Kolkata with snakebite from September 2023 to August 2024. the data assessed from an epidemiological perspective like age and gender and clinical perspective like the site of the bite, bite to niddle time, hypotension at presentation, coagulopathy at presentation, need for dialysis and progression to CKD is noted. Patients are followed up at discharge, at 30days, and 3 months for CKD progression. Univariate analysis followed by multivariate analysis done to look for clinical predictors of mortality, AKI and CKD progression.
Results:
Total 135 patients were enrolled in this study. Among them 75 were male (55.55%) and rest of them are female. The mean age 38.29 (95% CI of presentation 36.23-40.5). Mean bite to niddle time is 1.84hr. Mean of ASV 18.62 ± 1.27 vials. Bite to niddle time <4hr was15(11.11%) cases. 78 (57.77%) of people were in SAKI group. 113 (83.81%) of patients had bites on the lower limb. Deranged PT found in 30(22.23%) and found in 26 (20%). Platelet count less than 1.5 lack seen in case of 75 (45%) patients. 27 (20%) having DIC. Median of bite to AKI developing time 3 days. 70 (90%) patients needed HD. The median of the HD were 3 sessions.8 (10.25%) patients from AKI stage -1,50 (64.10%) Patients from Stage -2, 12 (15.38%) patients from Stage -3. 7 (8.97%) death occurs in SAKI group and most of them belongs to stage -3 AKI. Long-term follow up data available in 91 patients. 67 (85.89%) patients from SAKI group. 14 (17.94%) patients having abnormal renal function at 3 months follow up.
Conclusions:
SAKI still possess significant mortality and morbidity risk. Hypotension, coagulation abnormality, AKI stage at presentation and need for dialysis possess significant risk factors of adverse outcome. As well as long-term complication like CKD. Early renal recovery has better renal outcome. Patient having DIC at presentation have poor outcome in respect of mortality and CKD progression.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.