English

Abstract

BACKGROUND: Snakebite envenomation is a treatable occupational hazard in India which can present mainly as haemotoxicity or neurotoxicity. Haemotoxicity includes bleeding manifestations, capillary leak syndrome or disseminated intravascular coagulation and acute renal failure. Coagulation abnormalities like prolonged whole blood clotting time/prothrombin (PT)/activated partial thromboplastin (APTT) can determine the prognosis in these patients and is also essential to triage such patients for regular monitoring and follow up. MATERIALS AND METHODS: 50 snakebite cases admitted with systemic envenomation in the form of haemotoxicity (prolonged whole blood clotting time/PT/APTT) to VIMS Hospital, Bellary, during the period January 2012 to June 2013 were studied to determine the coagulation profile in relation to prognosis of patients. RESULTS: In this study, out of 50 patients, 35 were males and 15 were females. Age group between 20 to 40 years had higher number of systemic envenomation following snakebite. 26 patients had hematocrit >40%, of which 7 had PT/APTT of more than 1 minute. Out of 8 patients with clotting time more than 30 minutes, 7 patients had PT/APTT more than one minute. Out of 40 patients with prolonged PT/ APTT, 8 patients developed capillary leakage syndrome. Also, 6 developed early onset hypotension ( 24 hours). Complications included hypotension, acute renal failure, multi organ failure and DIC. Six patients died of complications secondary to snake envenomation of which, three patients died of multi organ failure, one died of sudden onset cardiorespiratory arrest and two patients died of acute renal failure. CONCLUSION: We have found a significant correlation of prolonged PT/APTT, clotting time >30 minutes and raised hematocrit with morbidity and mortality in hemotoxic snake bite and treating physicians should monitor such patients meticulously to prevent complications associated with it.