Correlation between laboratory indicators and severity of viper snakebite and limb swelling: a retrospective study in...

Snakebite envenomation remains a significant public health concern, with viper bites in southwestern China posing substantial clinical challenges due to complications such as coagulopathy and tissue swelling. The objective is investigate the correlation between laboratory indicators and the degree of limb swelling in patients with acute viper snakebites and to identify laboratory indicators for understanding the mechanisms involved in severity and swelling.

This retrospective study included patients presenting with confirmed viper snakebites to the emergency department of a regional medical center in southwest China between January 1, 2023, and December 31, 2023. Clinical data and laboratory results were collected and analyzed. Spearman's correlation and receiver operating characteristic curve analysis were performed to identify predictive indicators.

A total of 105 patients with a mean (±SD) age of 48.9 ± 16.6 years (61.0% male) were included. The neutrophil-to-lymphocyte ratio, white blood cell count, lactate dehydrogenase activity, creatine kinase activity, magnesium concentration, hydroxybutyrate dehydrogenase activity, and absolute neutrophil count were positively correlated with severity. Platelet count, low-density lipoprotein concentration, total cholesterol concentration, absolute lymphocyte count, eosinophil count, and albumin concentration were negatively correlated. For limb swelling, the D-dimer concentration, neutrophil-to-lymphocyte ratio, white blood cell count, absolute neutrophil count, and total cholesterol concentration showed positive correlations, while activated partial thromboplastin time, albumin concentration, absolute lymphocyte count, eosinophil count, low-density lipoprotein concentration, and magnesium concentration were negatively correlated.

These findings suggest that laboratory indicators can provide a rapid and objective assessment of both systemic severity and local swelling in viper snakebites, although heterogeneity in patient presentation and the retrospective, single-center design may limit generalizability.

Admission laboratory indicators may provide useful adjunctive information and mechanistic insight into the severity and swelling associated with viper envenomation, but they cannot replace rapid bedside clinical assessment for early swelling evaluation. These biomarkers should therefore be regarded as supportive tools, and future prospective studies are needed to validate their predictive value for clinical decision-making.