A retrospective study on snakebite and its outcome from a referral-cum-teaching hospital of Kolkata, India

Background: Snakebite-related fatality is among the highest in West Bengal and such patients display variety of clinical features. Precious time is also lost during the transport to health-care centers. Aim: The study was undertaken to find out the incidences and mortality associated with different snakebites and to compare the clinical features between the survivor and nonsurvivors. Materials and Methods: The data were derived from 286 indoor case records of snakebites from a referral hospital of Kolkata during January 2018 to September 2019. Patients' demographic details, exact bite history with subsequent management, clinical profile, and final outcome were compiled for analysis. Student's t-test and Fisher's exact test were performed to find out statistical significance. Results: The mean age of the patients was 28.44 ± 16.92 years and 69.23% were male. Overall, 67.13% of patients required hemodialysis and 13.63% ultimately died. Russell's viper caused the most number of bites (58.04%) and highest mortality (15.66%). Nonsurvivors had significantly higher levels of creatinine, urea, total count, total bilirubin, and prothrombin time and significantly low hemoglobin and platelet counts than that of the survivors. Bite-to-hospital time was also significantly prolonged among nonsurvivors (9.08 ± 9.68 h versus 4.64 ± 5.58 h; P = 0.0001). The highest (29.17%) mortality was observed among those who reported after 12 h of bite. Conclusion: Maximum snakebite-related mortalities were due to Russell's vipers in the current study. Patients with prolonged bite-to-hospital time were most vulnerable. Sepsis, coagulopathy, and acute kidney injury were significantly higher among the nonsurvivors.