Online ISSN: 2515-8260

Study of international normalized ratio and whole blood clotting time in patients with vasculotoxic snake bite at a tertiary hospital

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Revati Makarand Shende1 , Suvarna Patil2 , Pratap Jivan Shete3 , Ankita Sunil Kulkarni4

Abstract

ABSTRACT Background: Snake bite is a major health problem throughout the world, more so in tropical and sub-tropical countries. One of the most important effects of snake envenomation is hematologic abnormalities including coagulopathy, most commonly a venom-induced consumption coagulopathy (VICC). Present study was aimed to study international normalized ratio and whole blood clotting time in patients with vasculotoxic snake bite at a tertiary hospital. Material and Methods: Present study was single-center, prospective, comparative study, conducted in patients of age > 18 years, either gender, with history of snake bite, features suggestive of hemotoxic envenomation - Rapid extension of local swelling from site of bite or early spontaneous systemic bleeding or early systemic symptoms of collapse (hypotension and shock) or passage of cola coloured urine OR Whole blood clotting time more than 20 minutes OR INR > 1.5. Results: In present study, out of 91 snake bite cases, 51 cases were vasculotoxic (56.04 %). Mean age of study patients was 35.23 ± 11.34 years, majority were male (60.78 %). Among 51 cases, 20-minute WBCT was positive in 23 cases (45.1 %) & negative in 28 cases (54.9 %). Based on INR, Coagulopathy (INR >1.5) was noted in 30 cases (58.82 %) & Non-coagulopathy (INR ≤1.5) was noted in 21 cases (41.18 %). Sensitivity and specificity of 20-minute WBCT (by considering INR as standard) was 60 % & 76.19 % respectively. Positive predictive value & negative predictive value of 20-minute WBCT (by considering INR as standard) was 78.2 % & 57.14 % respectively. Conclusion: Sensitivity, specificity, positive predictive value & negative predictive value of 20- minute WBCT (by considering INR as standard) was 60 %, 76.19 %, 78.2 % & 57.14 % respectively.

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