Evaluation of Biochemical Markers and Clinical Outcomes in Snakebite Envenomation Patients in Mardan, Pakistan: A Hospital-Based Study

Background: Snakebite envenomation is a public health problem with significant morbidity and mortality in developing countries especially in the rural population and is affected by delays in seeking health care. Biochemistry may be useful in predicting the disease's severity and outcomes. This study aims to assess biochemical parameters and clinical outcomes in snakebite envenomation patients and determine the risk factors for adverse outcomes. Methods: The study was descriptive in nature and it was conducted at MTI-Mardan Medical Complex, Pakistan. All 91 adult patients with clinically suspected snake bite envenomation were selected by non-probability consecutive sampling. A structured proforma was used to collect the demographic, clinical, laboratory, treatment and outcome data. Laboratory investigations consisted of full blood count, coagulation profile, renal function tests, electrolyte levels and creatine kinase levels. The data were analyzed with SPSS version 25 and association tested by Chi-square or Fisher's exact test. Results: The mean age of participants was 42 ± 12 years, and 69.2% were male. Most patients belonged to rural areas (83.5%). Coagulopathy was the most common biochemical abnormality (22.0%), followed by elevated creatine kinase (17.6%), acute kidney injury (14.3%), and thrombocytopenia (13.2%). Complete recovery occurred in 81.3% of patients, while 16.5% developed complications and 2.2% died. Delayed hospital presentation, delayed antivenom administration, acute kidney injury, and the need for dialysis or ventilatory support were significantly associated with adverse outcomes (p<0.05). Conclusion: Snakebite envenomation is associated with significant biochemical derangements, particularly coagulopathy and acute kidney injury. Early presentation, prompt antivenom administration, and close monitoring are essential to improve clinical outcomes.