Skip to main content

Free Content Clinical predictors of in-hospital mortality in patients with snake bite: a retrospective study from a rural hospital in central India

Download Article:

You have access to the full text article on a website external to ingentaconnect.

Please click here to view this article on Wiley Online Library.

You may be required to register and activate access on Wiley Online Library before you can obtain the full text. If you have any queries please visit Wiley Online Library


Summary Objective 

To determine the association between selected admission risk factors and in-hospital mortality in patients admitted with venomous snake bite to a rural tertiary care hospital in central India. Methods 

Retrospective cohort study of patients aged 12 years or older admitted to a rural hospital in central India between January 2000 and December 2003 with venomous snake bites. The primary endpoint was in-hospital mortality. We used Cox proportional-hazards regression analysis to evaluate the association between risk factors (home-to-hospital distance, bite-to-hospital time, vomiting, neurotoxicity, urine albumin, serum creatinine concentration and whole-blood clotting time) and in-hospital mortality. Results 

Two hundred and seventy-seven patients [mean age 32 (SD 12) years; 188 men (68%)] were admitted with venomous snake bite, 29 patients (11%) died. The probability of survival at day 7 was 83%. Vomiting [hazard ratio 6.51 (95% CI 1.94–21.77), P ≤ 0.002], neurotoxicity [hazard ratio 3.15 (95% CI 1.45–6.83), P = 0.004] and admission serum creatinine concentration [hazard ratio 1.35 (95% CI 1.17–1.56), P ≤ 0.001] were associated with higher risk of death in the adjusted analysis. Conclusions 

In our rural hospital setting, the overall mortality rate was 11 per 100 cases of snake bite. Vomiting, neurotoxicity and serum creatinine are significant predictors of mortality among inpatients with snake bite. These predictors can help clinicians assess prognosis of their patients more accurately and parsimoniously and also serve as useful signposts for clinical decision-making.

Keywords: India; envenoming; mortality; predictors; risk factors; snake bites; survival

Document Type: Research Article


Affiliations: 1: Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India 2: Division of Epidemiology, University of California at Berkeley, Berkeley CA, USA

Publication date: January 1, 2006


Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
Cookie Policy
ingentaconnect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more