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Snake bite mortality in children: beyond bite to needle time

M P Jayakrishnan1, M G Geeta1, P Krishnakumar1

  • 1Government Medical College, Kozhikode, Kerala, India.

Archives of Disease in Childhood
|November 4, 2016
PubMed

Insights

Severe leucocytosis and acute kidney injury are key predictors of mortality in children with snake bite envenomation. Early identification of these factors can improve management strategies for pediatric snake bites.

Area of Science:

  • Pediatric critical care medicine
  • Toxicology
  • Epidemiology of envenomation

Background:

  • Snake bite envenomation is a significant health concern in children, particularly in South Asia.
  • Understanding the clinical profile and mortality predictors is crucial for effective management.

Purpose of the Study:

  • To investigate the clinical characteristics of snake bite envenomation in children.
  • To identify independent predictors of mortality in pediatric snake bite cases.

Main Methods:

  • Prospective observational cohort study involving 145 children (<12 years) with snake bite envenomation.
  • Data collected on demographics, clinical features, treatment with polyvalent antisnake venom (ASV), complications, and outcomes.
  • Statistical analysis included univariate and binary logistic regression.

Main Results:

  • Russell's viper and hump-nosed pit viper were common culprits. Hemotoxicity and neurotoxicity were frequent manifestations.
  • Acute kidney injury (AKI) occurred in 25% of children; mortality rate was 10.3%.
  • Severe leucocytosis on day 1 and AKI were identified as independent predictors of mortality.

Conclusions:

  • Severe leucocytosis on day 1 and AKI are significant, previously unrecognized risk factors for mortality in pediatric snake bites.
  • These findings highlight the need for vigilant monitoring and prompt intervention for these specific indicators.
  • Informing management strategies for childhood snake bite envenomation is essential.
Abstract

Keywords:
Intensive CareMortalityTropical Paediatrics

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