Pal Tarun, Chaudhary Shyam C, Usman Kauser, Sawlani Kamal K, Kumar Vivek, Gupta Kamlesh K, Singh Abhishek, Kumar Amit, Sinha Shambhavi
Junior Resident, Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India, Corresponding Author.
Professor, Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India.
J Assoc Physicians India. 2025 Jun;73(6):13-17. doi: 10.59556/japi.73.1001.
Snakebites represent a critical occupational hazard for individuals working in agriculture and outdoor labor, leading to significant global morbidity and mortality. Despite their impact, accurate global data are scarce due to patients often seeking traditional remedies over formal healthcare. This study aims to analyze the clinical, biochemical, and cardiac profiles of snakebite patients at a tertiary care center in Northern India.
This prospective observational study was conducted at a tertiary care center. It included patients aged ≥13 years who presented with snakebites. Baseline investigations were done, and treatment outcomes, complications, and survival rates were monitored. Statistical analysis was performed using Statistical Package for Social Science (SPSS) version 24.0.
Of 120 snakebite patients, 20% were under 18 years, 58.3% were aged 18-45 years, and 21.7% were over 45 years. The mean age was 32.59 ± 15.53 years, with a male-to-female ratio of 6:5. Most patients were farmers (35%) and from rural areas (93.3%). Snakebites predominantly occurred during the monsoon season, affecting the lower limbs (69.2%). Delayed presentation (>6 hours) was common, linked to increased complications. The most frequent complications were acute renal failure (ARF) (14.2%) and respiratory failure (13.3%). Mean troponin T levels were higher in deceased patients (0.060 ± 0.176) compared to survivors (0.011 ± 0.066), though this difference was not statistically significant ( = 0.077). N-terminal pro B-type natriuretic peptide (proBNP) levels were significantly higher in the deceased group (1,668.8 ± 4,625.2) compared to survivors (374.66 ± 780.53) ( = 0.010). Electrocardiogram (ECG) abnormalities included sinus tachycardia (25%) and T-wave inversion (5%). The mean hospitalization duration was 3.42 ± 2.17 days for survivors and 4.00 ± 2.50 days for deceased patients, without significant correlation to outcome.
The study found an association between delayed hospital arrival and increased complications. Elevated potassium and serum glutamic-oxaloacetic transaminase (SGOT) levels were also observed in deceased patients, alongside higher respiratory rates (RRs) and lower blood pressures and Glasgow Coma Scale (GCS) scores. ProBNP level was found to be significantly higher in deceased patients.
蛇咬伤是从事农业和户外劳动的人员面临的一项重大职业危害，导致全球大量发病和死亡。尽管其影响重大，但由于患者常常寻求传统疗法而非正规医疗保健，准确的全球数据稀缺。本研究旨在分析印度北部一家三级医疗中心蛇咬伤患者的临床、生化和心脏状况。
这项前瞻性观察性研究在一家三级医疗中心进行。纳入年龄≥13岁的蛇咬伤患者。进行了基线调查，并监测治疗结果、并发症和生存率。使用社会科学统计软件包（SPSS）24.0版进行统计分析。
在120例蛇咬伤患者中，20%年龄在18岁以下，58.3%年龄在18 - 45岁之间，21.7%年龄超过45岁。平均年龄为32.59±15.53岁，男女比例为6:5。大多数患者是农民（35%），来自农村地区（93.3%）。蛇咬伤主要发生在季风季节，影响下肢（69.2%）。延迟就诊（>6小时）很常见，与并发症增加有关。最常见的并发症是急性肾衰竭（ARF）（14.2%）和呼吸衰竭（13.3%）。与幸存者（0.011±0.066）相比，死亡患者的肌钙蛋白T平均水平更高（0.060±0.176），尽管这种差异无统计学意义（P = 0.077）。死亡组的N末端B型利钠肽原（proBNP）水平显著高于幸存者（374.66±780.53）（1,668.8±4,625.2）（P = 0.010）。心电图（ECG）异常包括窦性心动过速（25%）和T波倒置（5%）。幸存者的平均住院时间为3.42±2.17天，死亡患者为4.00±2.50天，与结局无显著相关性。
该研究发现延迟就医与并发症增加之间存在关联。在死亡患者中还观察到血钾和血清谷草转氨酶（SGOT）水平升高，同时呼吸频率（RRs）更高，血压和格拉斯哥昏迷量表（GCS）评分更低。发现死亡患者的proBNP水平显著更高。
