Background and objectives: A study of correlation between Bite to needle time and acute kidney injury in patients admitted with snake bite and systemic envenomation and an analysis of the outcome of these patients.
Materials and Methods: 100 cases admitted at Government Mohan Kumaramangalam Medical college Hospital, Salem, during the period April 2015 to March 2016, with clinical evidence of snake bite envenomation were included in the study after taking into account the inclusion and exclusion criteria. Out of the 100 cases, 56 were males and 44 were females. All the 100 cases were treated for snake envenomation and their laboratory work up and follow up data were collected and studied.
Results: 44% of Snake bite victims have developed Acute Kidney Injury. Delay in admission was strongly correlated with development of Severe AKI (P<0.0005). Victims with co-morbidities are more prone to develop AKI and Complications in addition to time delay. Most of the patients with AKI (93%) had Cellulitis and Lymphadenopathy (P<0.05). AKI is uncommon in Patients without coagulopathy. 80% of patients were required conservative management only. 90% of AKI Patients recovered completely (P<0.0005). Only 6 patients of Stage 3 AKIN (24%) become dialysis dependent. 4 patients in AKIN 3 group (16%) died due to complications of AKI (P<0.0005). People who were initiated on prompt medical therapy earlier and follow up showed signs of early recovery and favorable prognosis. This was also corroborated with the laboratory work up results of these patients.
Conclusion: Early admission to the hospital and early administration of Inj.ASV with adequate supportive therapy is important to prevent development severe Acute Kidney Injury and its complications. The morbidity and mortality is high if severe cellulitis is associated with prolonged coagulopathy.