# Association between diabetes and disease severity in patients with venomous snakebites: A Multicenter Retrospective Analysis

## TL;DR

This study finds that diabetes significantly increases the severity of venomous snakebites and leads to worse outcomes like longer hospital stays and higher costs.

## Contribution

The study identifies diabetes as an independent predictor of increased severity in snakebite patients, with notable sex differences in outcomes.

## Key findings

- Diabetes is an independent predictor of increased snakebite severity with an odds ratio of 5.51.
- Females with diabetes had a higher risk of moderate-to-severe outcomes compared to males.
- Diabetes was associated with longer hospital stays, higher costs, more complications, and increased need for surgery.

## Abstract

Snakebites remain an overlooked public health issue with high morbidity and mortality. In this study, we assess the impact of diabetes on disease severity in patients with venomous snakebites.

A retrospective cohort analysis was conducted on snakebite cases treated at eight hospitals in Fujian Province between December 2019 and December 2023. Snakebite severity was evaluated using the Snakebite Severity Score. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with snakebite severity.

The study included 537 patients. The average age of patients is 55 years. 54.93% (n = 295) were aged ≥55 years, 57.17% (n = 307) were male, and 13.41% (n = 72) had diabetes. In the multivariate logistic regression, diabetes (odds ratio [OR] = 5.51; 95% confidence interval [CI]: 3.18–9.55), time from snakebite to hospital (OR = 1.04; 95% CI: 1.01–1.07), and bite site (OR = 0.63; 95% CI: 0.41–0.97) were identified as independent predictors of snakebite severity. Subgroup analysis revealed significant sex differences among patients with diabetes. The odds ratio for moderate-to-severe outcome was 3.81 (95% confidence interval [CI]: 1.81–7.99) in males and 12.57 (95% CI: 5.72–27.60) in females, with an interaction p-value of 0.030. Additionally, diabetes was significantly associated with prolonged hospital length of stay (p < 0.01), increased costs (p < 0.01), higher complication rates (p < 0.01), and a greater likelihood of requiring debridement surgery (p < 0.01) compared to individuals without diabetes.

Diabetes is an independent predictor of disease severity in patients with snakebites, underscoring the need for clinicians to consider the diabetes status when assessing and managing snakebite risk. These findings provide valuable insights for optimizing care strategies for individuals with diabetes who have experienced venomous snakebites.

This study aims to evaluate the impact of diabetes on the severity of venomous snakebites, a significant but often overlooked public health issue. A retrospective cohort analysis was conducted on 537 snakebite patients treated at eight hospitals in Fujian Province between December 2019 and December 2023. The Snakebite Severity Score was used to assess severity, and both univariate and multivariate logistic regression analyses were performed to identify contributing factors. The results showed that diabetes was a significant independent predictor of increased snakebite severity, with an odds ratio (OR) of 5.51. Other factors influencing severity included the time from snakebite to hospital and the bite site. Subgroup analysis revealed notable sex differences, with females with diabetes having a much higher risk of moderate-to-severe outcome than males. Additionally, diabetes was associated with longer hospital stays, higher medical costs, increased complication rates, and a higher likelihood of requiring debridement surgery. These findings highlight diabetes as an important risk factor for worsened outcomes in patients with venomous snakebites, emphasizing the need for more focused care and intervention in this population.