Snakebite envenomation: A comprehensive evaluation of severity, treatment, and outcomes in 100 patients correlating timing of ASV administration with complications

Abstract

This study, conducted at the New Civil Hospital in Surat from June 2004 to November 2006, explored the clinical dynamics, complications, and outcomes of 100 cases of poisonous snakebites. The age group most affected was 21–40 years (58%), reflective of heightened outdoor activities. Males, often primary earners, exhibited a higher incidence, while rural areas dominated (75%) due to favorable snake habitats. Notable patterns emerged, such as a significant occurrence of bites between 6:00 p.m. and 5:59 a.m. attributed to nocturnal snake activity and rural sleeping habits. The monsoon season experienced a peak in snakebites (79%) as snakes sought refuge in human habitats. Intriguingly, 45% of patients lacked visible fang marks, challenging their reliability for identifying venomous bites. Neurotoxicity prevailed (54%), with local pain and swelling prominent. Effective treatment resulted in a 90% cure rate, highlighting the significance of early diagnosis. Respiratory failure, hypotension, and combined manifestations indicated poor prognosis, underscoring the critical need for early recognition. Mechanical ventilation notably reduced mortality in neurotoxic cases. Delayed admission correlated with heightened severity, complications, and poorer outcomes, emphasizing the urgency of early intervention. Severity grades 3 and 4 exhibited elevated mortality rates, calling for urgent and meticulous management. The duration of venom in the bloodstream before antivenom administration directly impacted severity and outcomes. Future research avenues include species-specific considerations, antivenom advancements, community education, remote healthcare solutions, and long-term follow-up. Limitations encompass single-center data, incomplete records, temporal constraints, limited species identification, and a need to delve into social and cultural factors influencing snakebites.