Comparative Evaluation of Whole Blood Clotting Test as a Diagnostic Predictor of Venom Induced Consumption Coagulopathy in Hemotoxic Snake Bite

Background: Venomous snakebites are a significant concern in South-East Asia, with an annual death toll of approximately 45,900 in India, higher in rural areas and during the rainy season.States like Uttar Pradesh, Andhra Pradesh, Bihar, and Odisha report the highest cases.Odisha's venomous snakes include neurotoxic kraits and cobras, myotoxic sea snakes, and hemotoxic species.The aim is to compare WBCT at 20 and 30 minutes as a better predictor of venom-induced coagulopathy and to determine its sensitivity and specificity.Methods: In this study, for each patient before giving ASV 2ml venous blood was drawn for 20 minutes WBCT and 30 minutes WBCT and put in two clean, dry, ordinary test tubes at room temperature.Simultaneously, other blood samples were sent PT, INR, aPTT, D dimer, and serum fibrinogen to the clinical haematology laboratory SCB MCH.These tests were repeated at 6 hours after 1st dose of ASV.Results: Most cases were from rural areas and presented late to the hospital.Fang marks were observed in 41% of cases, with bleeding, oliguria, and haematuria in 5%, 8%, and 6% respectively.Bites mostly occurred during cultivation in the rainy season (73%).WBCT20 showed a sensitivity of 84.72%, specificity of 64.29%, PPV of 85.92%, and NPV of 62.07%.WBCT30 had a sensitivity of 80.28%, specificity of 72.41%, PPV of 87.69%, and NPV of 60%. Conclusion:The study investigates whether WBCT30 offers advantages over the accepted standard WBCT20 for detecting snake venom-induced coagulopathy.