Predictors of Antivenom Administration and Dose Requirement among Snakebite Patients: A Prospective Observational Study from a Tertiary Government Hospital in Tamil Nadu, India
DOI:
https://doi.org/10.55489/njcm.170620266224Keywords:
Antivenoms, Predictors, Snake bite, EnvenomationAbstract
Background: Snakebite envenoming is a neglected tropical disease-causing significant mortality and morbidity globally. Considerable variability exists in antivenom administration practices. This study aimed to identify predictors of anti-snake venom (ASV) administration and dose requirements among snakebite patients.
Methods: A prospective observational study was conducted at a tertiary government hospital in Tirunelveli, Tamil Nadu, over two months (October–November 2022). A total of 139 patients admitted to intensive care units with snakebite history were enrolled using consecutive sampling. Bivariate and multivariate logistic and linear regression analyses were performed to identify predictors of ASV use and dosing.
Results: ASV was administered to 82 (58.9%) patients. Snake identification (AOR=4.95; p=0.007) and pain at bite site (AOR=2.81; p=0.017) were independent predictors of ASV administration. Bleeding at the bite site (β=0.592; p=0.021), lymphadenopathy (β=0.544; p=0.037), and neurotoxic envenomation (β=-0.861; p=0.005) were significant predictors of higher ASV dose requirements. Mortality was nil and adverse reactions were mild (9.7%).
Conclusion: Snake identification and pain at bite site predict ASV administration, while bleeding, lymphadenopathy, and envenomation type determine dose requirements, enabling rational, protocol-driven antivenom use.
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