Prognostic factors in haemotoxic viper bite: analysis of data from a referral hospital

To identify the predictors of severe outcomes in patients with haemotoxic viper bite certain independent variables were recorded like age, sex, ethnicity, bite sites, duration of prehospital period, prehospital treatment, onset of systemic bleeding, local oedema, ecchymoses, blister, hematocrit, platelet count, whole blood clotting time, serum electrolytes, renal function and urinary examination findings in 62 hoptalised patients. Forward stepwise logistic regression was used for analysis of the independent factors predicting outcomes. Systemic bleeding was the commonest complication (45%). On multivariate analysis, alteration in coagulation parameters (like thrombocytopenia and prolonged whole blood clotting time) predisposed to systemic bleeding while local factors like bite site, faulty tourniquet application, and herbal treatment were responsible for local complications. Factors like massive envenomation and delayed hospitalisation significantly contributed to major organ damage. Predictors of death were anuria and systemic bleeding. It is concluded that several epidemiological, clinical, and laboratory features predict adverse outcomes in haemotoxic viper bite.