A Study of Clinicobiochemical and Cardiac Profile in Snakebite at a Tertiary Care Center in Northern India

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 (p = 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) (p = 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.