Экстренная медицина: открытый доступ
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ISSN: 2165-7548
ISSN: 2165-7548
Nivedita Sharma, Piyush Gautam, Sanjeev Choudhary, Vipin Roach and Ankush Kaushal
Snake bite is a common life-threatening condition in many tropical countries. The highest burden of snakebites is in South Asia, Southeast Asia, and sub-Saharan Africa. Among these, India has the highest incidence of mortality from snakebite annually. Children are more prone for severe envenomation and complication due to lesser body surface area. This study was aimed at analyzing predictors of severity and factors involved in adverse outcome in pediatric snake envenomation. A descriptive evaluation for outcome determinants of snake envenomation was carried out based on a clinico – laboratory severity grading scale, among 60 out of 71 patients with envenomation in a tertiary care hospital in northern India from January 2008 to December 2013. Analysis was done using SPSS 17 trial version. Student t-test (unpaired), chi square tests, analysis of variance, coefficient of correlation and logistic regression were used to find out the predictors. Predictors associated with adverse outcome were neurotoxic envenomation, absence of local envenomation and cardiovascular involvement (OR 76.66, 95% CI (6.65-883.23), p value 0.001). Leucocytosis (pvalue<0.07), thrombocytopenia (p value<0.05), prolonged 20 minute clotting time (p value 0.008) were associated with severe envenomation and hence more complications. There was a relationship between grade of envenomation and the length of hospitalization (p=0.04), a shorter duration of hospital stay being associated with poor outcome (OR 0.425, 95% CI (0.212- 0.851), p value 0.02). So in order to reduce the mortality from snake bite, it is important for the patient to reach the hospital as early as possible so as to get timely and appropriate treatment with anti-snake venom to prevent the development or progression of complications.