The value of coagulation parameters as prognostic indicators in snake envenomation

Snakebite is a potentially life-threatening emergency that can be treated effectively. Snake envenomation can cause hematologic and coagulation abnormalities. In this respect, tests such as prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) are commonly used. The present study aimed to determine the value of coagulation parameters in the prognostication of snakebite patients.

This prospective descriptive observational study examined the coagulation parameters, including PT, INR, and aPTT, in consecutive cases of snake envenomation admitted to a tertiary health care hospital from October 2019 to August 2021. The correlation of coagulation parameters with each other and with prognostic indicators (ie, the number of days spent in the intensive care unit [ICU], the requirement of anti-snake venom [ASV], fresh frozen plasma [FFP], and the total number of blood products) was studied.

A total of 58 patients with snakebite were studied. The majority were males (69%). The highest proportion of patients belonged to the age group of 16-40 years (60%). The correlation of coagulation parameters with each other was statistically significant. The correlation of coagulation parameters with prognostic indicators (ie, the total number of ASV vials administered, the total number of days in the ICU, the total number of FFP units administered, and the total number of blood components administered) was statistically significant.

Coagulation parameters (PT, INR, and aPTT) are essential laboratory investigations for treatment monitoring and can be used effectively for the prognostication of snakebite patients. In cases where the coagulation profile of snakebite patients shows abnormalities, conducting repeated coagulation studies at intervals of 12 hours can contribute to improved prognostication.