Snake Bite Induced Coagulopathy: A Study of Clinical Profi le and Predictors of Poor Outcome

Original Article

  • H S Harshavardhana Assistant Professor of Anesthesiology
  • Imtiaz Pasha Assistant Professor of Emergency Medicine
  • N C Srinivasa Prabhu Professor of Emergency Medicine
  • Amira Junior Resident, Department of Emergency Medicine
  • Preethika Ravi Junior Resident, Department of Emergency Medicine
Keywords: Coagulopathy, Snake bite


Background: Snake bite poisoning is known to man since antiquity. Snake bite can result in local and systemic complications.
Major systemic complications include acute renal failure, neurologic abnormalities requiring ventilator support and disseminated
intravascular coagulation. Disseminated intravascular coagulation can result in serious life threatening systemic complications
like hemorrhage, infarction and even death if the treatment is delayed. In tropical countries where snake bite is a serious problem
there is very little reliable data on hematological problems of snake envenomation because of inadequate documentation.
Aims: The present study was undertaken to study the clinical profi le of the snake bite patients who develop coagulopathy and
to study the role of coagulation markers to evaluate the morbidity and mortality of snake bite victims.
Material and Methods: Fifty patients consecutively admitted with history of snakebite were studied from May 2012 to November
2013 in a Kempegowda institute of medical sciences (KIMS), Bangalore, Karnataka, India. The patients were classifi ed into the
normal and coagulopathy group based on clinical symptoms and the hematological parameters.
Results: In our study patients who had coagulopathy had prolonged hospital stay and requirement of more blood products
transfusion causing increased morbidity. 24 patients had platelets less than 1 lakh and approximately hospitalized for 28 days
and they received 102 platelet units. INR was more than 1.5 in 24 patients and hospitalized for 25 days and they received 136
fresh frozen plasma. The case-fatality rate in our study was 4%.
Conclusion: Combined clinical and laboratory parameter evaluation needed to identify the coagulopathy very early to reduce
the hospital stay and mortality.

Author Biographies

H S Harshavardhana, Assistant Professor of Anesthesiology

Kempegowda Institute of Medical Sciences (KIMS), Bangalore

Imtiaz Pasha, Assistant Professor of Emergency Medicine

Kempegowda Institute of Medical Sciences (KIMS), Bangalore

N C Srinivasa Prabhu, Professor of Emergency Medicine

Kempegowda Institute of Medical Sciences (KIMS), Bangalore

Amira, Junior Resident, Department of Emergency Medicine

Kempegowda Institute of Medical Sciences (KIMS), Bangalore

Preethika Ravi, Junior Resident, Department of Emergency Medicine

Kempegowda Institute of Medical Sciences (KIMS), Bangalore


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Original Articles