A Retrospective Study on Snakebite Victims in a Tertiary Referral Center

Nasim Zamani,Leila Modir-Fallah Rad,Kambiz Soltaninejad,Shahin Shadnia

doi:10.32598/ijt.10.4.332.1

Abstract

Background: Snakebite is a serious public health problem in the world. The annual incidence of snakebites ranges from 4.5-9.1 in 100,000 population in Iran. With regard to diversity of envenomation profiles in different geographical parts of Iran, the aim of this study was to determine the demographical data, clinical and laboratory findings, and the outcome of the snakebite victims referred to a tertiary referral hospital. Methods: In this retrospective, cross-sectional study in Loghman Hakim Hospital Poisoning Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, during a four-year period from March 2007 to March 2011. The demographic data, clinical manifestations, paraclinical findings, treatments performed before hospital admission, time elapsed between the bite and hospital admission, total dose of antivenom and the patients’ outcomes were investigated. Results: Seventy cases (58 males, 12 females) were evaluated. Most of the cases (79%) were older than 20 year old. The most common bite site was upper extremity (67%). Most of the patients were admitted within 5 h after the snakebite. The most common local and systemic manifestations were swelling (90%), pain (81.4%), nausea and vomiting (24.3%). Leukocytosis (35.7%) and thrombocytopenia (25.7%) were the most common laboratory abnormalities. Most of the patients (97.1%) were treated with antivenom. Fifty percent of the patients only received 3-5 vials of antivenom. The mortality rate was 1.4%. Necrosis of the toes and compartment syndrome were the only serious complications. Conclusion: The findings emphasize the importance of early admission to the hospital and treatment with antivenom to avoid morbidity and mortality.

Highlights

Snakebite is a serious health problem that can cause a wide range of complications in patients
With regard to the diversity of envenomation profiles in different geographical parts of Iran, we aimed to evaluate the demographic characteristics, clinical and paraclinical manifestations of snakebites in victims referred to a tertiary poisoning center in Tehran, the capital of Iran, during a four-year period
The demographic data, clinical manifestations and paraclinical findings including sex, age, bite site, treatments performed before hospitalization, time elapsed between the bite and hospital admission, local and systemic signs and symptoms, white blood cell counts (WBC), platelet (PLT), prothrombin time (PT), partial thromboplastin time (PTT), creatinine (Cr), urine analysis, liver function tests, serum sodium (Na) and potassium (K) levels, total dose of antivenom, and the outcome of the victims were extracted from the patients' medical files

Summary

Introduction

Snakebite is a serious health problem that can cause a wide range of complications in patients. The annual incidence of snakebites ranges from 4.5-9.1 in 100,000 population in Iran. With regard to diversity of envenomation profiles in different geographical parts of Iran, the aim of this study was to determine the demographical data, clinical and laboratory findings, and the outcome of the snakebite victims referred to a tertiary referral hospital. The demographic data, clinical manifestations, paraclinical findings, treatments performed before hospital admission, time elapsed between the bite and hospital admission, total dose of antivenom and the patients’ outcomes were investigated. Conclusion: The findings emphasize the importance of early admission to the hospital and treatment with antivenom to avoid morbidity and mortality.

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Conclusion