ArticleRevista da Sociedade Brasileira de Medicina Tropical2026
Outcomes Associated With the Timing of Antivenom Administration in Bothrops and Crotalus Snakebite Envenomations.
Article in Revista da Sociedade Brasileira de Medicina Tropical, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSnakebite envenomation is a significant public health problem. We aimed to analyze the clinical outcomes associated with the timing of antivenom administration in Bothrops and Crotalus snakebite envenomations.
methodsThis descriptive, retrospective, census-based cohort study included patients who attended the Toxicological Information and Assistance Center-Londrina from 2017 to 2024. Sociodemographic, clinical, exposure-related, and antivenom therapy data were obtained from the national DATATOX system and clinical records. Descriptive statistics and Poisson regression (for relative risks [RRs] and 95% confidence intervals [CIs]) were used; significance was set at p<0.05.
resultsData from 1,162 cases were analyzed, with 72.8% caused by Bothrops and 27.2% by Crotalus. Most patients were male (78.6%), rural workers (59.0%), and residents of rural areas (88.4%). Antivenom therapy was administered with 98.2% adequacy, according to institutional protocols. The median time from bite to completion of antivenom infusion was 450 minutes, with 75% of patients treated within 12 hours; 2.7% of patients developed renal complications and 1.1% died. Both outcomes were more frequent among patients with longer intervals between the bite and antivenom administration (>75th percentile). In the crude analysis, delays were associated with renal complications (RR: 3.21; 95% CI: 1.61-6.41; p=0.001) and death (RR: 4.81; 95% CI: 1.59-14.59; p=0.006). After adjustment, the association remained significant for renal complications (RR: 2.88; 95% CI: 1.37-6.06; p=0.005), but not for death.
conclusionsDelayed antivenom administration is associated with an increased risk of renal complications, reinforcing the timing of therapy as a critical and modifiable factor influencing snakebite outcomes.
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