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Retrospective Hospital-Based Cohort Study on Risk Factors of Poor Outcome in Pediatric Snake Envenomation

Ganapathi Suryanarayana1, Ramachandran Rameshkumar1, Subramanian Mahadevan1

  • 1Division of Pediatric Critical Care, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605 006, India.

Journal of Tropical Pediatrics
|December 6, 2020
PubMed

Insights

In pediatric snakebite envenomation, young age, playing or walking during the bite, delayed antivenom, and neurotoxic venom increase poor outcomes. Early intervention and appropriate antivenom administration are crucial for better results in children.

Area of Science:

  • Pediatric Toxicology
  • Clinical Medicine
  • Epidemiology

Background:

  • India faces the highest mortality from snakebite envenomation in Southeast Asia.
  • Pediatric snakebite envenomation presents unique challenges and risk factors for severe outcomes.

Purpose of the Study:

  • To identify risk factors associated with poor outcomes in children under 13 years old who experienced snakebite envenomation.
  • To analyze factors contributing to mortality, mechanical ventilation, or renal replacement therapy (RRT) in pediatric snakebite cases.

Main Methods:

  • Retrospective review of case records for children under 13 admitted with snakebite envenomation from June 2009 to July 2015.
  • Exclusion criteria included death within 6 hours, RRT before antivenom, and unknown bite details.

Main Results:

  • Out of 308 patients, 128 (41.6%) had poor outcomes, and 36 (11.7%) died.
  • Independent predictors of poor outcome included age ≤5 years, activity (walking/playing), no tourniquet use, bite-to-antivenom time >6 hours, fang marks, neurotoxic envenomation, and additional antivenom doses.

Conclusions:

  • Younger age, specific activities during envenomation, delayed antivenom, and neurotoxic type are significant risk factors for adverse outcomes in pediatric snakebites.
  • Identifying these predictors can guide targeted interventions and improve management strategies for snakebite envenomation in children.
Abstract

Keywords:
childrenenvenomationpoor outcomerisk factorsnakebite

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