Nucleotidase as a Clinical Prognostic Marker in Snakebites: A Prospective Study.

Abstract

Background: Snakebite envenomation is a critical global health issue, causing substantial mortality and morbidity. Snake venom includes various enzymes, such as nucleotidase, phosphatases, etc. which impact physiological functions. However, research on the role of serum 5'-nucleotidase levels in assessing the severity and outcomes of snakebites is limited. This study aims to measure serum 5'-nucleotidase levels and explore their correlation with the severity of envenomation, to better understand its role in predicting patient prognosis.

Methods: This is a single-center, prospective observational analysis involving 82 snakebite patients. Serum 5'-nucleotidase levels were measured using enzyme-linked immunosorbent assay, and clinical severity was evaluated using the snakebite severity score (SSS). Statistical analyses were performed to determine the correlation between 5'-nucleotidase levels and SSS, as well as various complications.

Results: Among the 82 snakebite patients, 71.9% were male and 28.1% were female. Most bites (62.2%) occurred during the day, and 83% involved the lower limbs. Recovery was high, with 93.9% discharged, 3.7% deceased, and 2.4% lost to follow-up. A positive correlation was observed between 5'-nucleotidase levels and SSS at both 0 and 24 hours, with correlation coefficients of 0.55 and 0.61, respectively (p < 0.001).

Conclusion: Serum 5'-nucleotidase serves as an effective biomarker for assessing the severity of snakebite envenomation and predicting patient outcomes. Its strong correlation with clinical severity scores makes it a valuable tool for improving the prognostication and management of snakebite cases when used in conjunction with clinical assessments.

How to cite this article: Kaulgud RS, Hasan T, Astagimath M, Vanti GL, Veeresh S, Kurjogi MM, et al. Nucleotidase as a Clinical Prognostic Marker in Snakebites: A Prospective Study. Indian J Crit Care Med 2025;29(2):125-129.