Incidence, Mechanisms, and Clinical Outcomes of Hyponatremia in Venomous Snakebite Envenomation: A Cross-Sectional Study from South India

Background:

Snakebite envenomation is a major neglected tropical disease associated with significant morbidity and mortality. Endocrine complications, particularly hyponatremia, remain understudied despite their potential for severe outcomes.

Aims and Objectives:

To determine the incidence of hyponatremia in patients with venomous snakebites and to examine its association with snake type, clinical severity, and outcomes.

Materials and Methods:

This observational cross-sectional study included 100 adult patients with confirmed venomous snakebites admitted to a tertiary care hospital in Coimbatore, India, from January 2024 to January 2025. Serum sodium levels were measured at admission and serially. Demographic, clinical, and laboratory data were analyzed using descriptive statistics, chi-square, and t-tests.

Results:

Hyponatremia (serum Na⁺ <135 mEq/L) occurred in 38% of patients. Viper bites showed significantly higher incidence (52.1%) than elapid bites (26.2%, p=0.014). Hyponatremic patients had longer hospital stays (7.8 vs. 4.9 days, p<0.001) and higher rates of acute kidney injury (36.8% vs. 12.9%, p=0.005).

Conclusion:

Hyponatremia is common in venomous snakebites, especially viper envenomation, and is linked to worse clinical outcomes. Routine electrolyte monitoring and targeted management are recommended to improve prognosis.