Effect of Delayed Presentation on the Prognosis of Snakebite Victims at a Tertiary Care Hospital: The Golden Hour Matters

Introduction:

Snakebite envenomation is one of the important public health problems in India, and many deaths and morbidity in rural areas are attributed to snakebite envenomation.

Objective:

This study aimed to evaluate the impact of time from bite to hospital on clinical outcomes of snakebite patients admitted to a tertiary care centre in Uttar Pradesh.

Methodology:

A cross-sectional observational study was conducted at All India Institute of Medical Sciences (AIIMS), Raebareli, for a period of one year, from March 2025 to March 2026. A total of 30 envenomated patients who were confirmed to have been bitten by snakes were included and divided into four groups: Group I (patients bitten within six hours), Group II (six to 12 hours), Group III (12-18 hours), and Group IV (18-24 hours). Severity of disease, systemic toxicity, anti-snake venom (ASV) requirements, complications, and mortality were assessed. Results: The mean age was 28.0 years (range 9-70). Most patients were male (53.3%) and from low socioeconomic backgrounds (53.3%). Lower limb bites predominated (53.3%). Dyspnoea and drowsiness were universal (100%). Out of four deaths, one occurred in patients presenting within six hours and three deaths in patients presenting between 18 and 24 hours, with 75% mortality in the 18-24-hour group (3/4) versus 7.1% in the zero-to-six-hour group (1/14). Recovery rates were highest in the zero-to-six-hour group (71.4%).

Conclusion:

Delayed hospital presentation is strongly associated with worse outcomes in snakebite envenomation. The "golden hour" p