Predictive Modeling of Necrotizing Skin Infections in Snakebite Patients

Venomous snakebites are a significant public health issue, particularly in tropical and subtropical regions like southern China. Necrotizing skin infections are a severe but relatively rare complication of venomous snakebites, often resulting from delayed treatment and bacterial invasion. This study retrospectively analyzed clinical data from 99 patients with venomous snakebites treated at three hospitals in Guangdong Province between January 2020 and April 2024. The primary objective was to identify the major risk factors associated with the development of necrotizing skin infections and to build a predictive model to assist in clinical decision-making.

The study included male and female patients aged 14 years and older. Patients with incomplete medical records, long-term use of immunosuppressants, or underlying immunodeficiency diseases were excluded. Multivariate logistic regression identified the Snakebite Severity Score (SSS), blood glucose levels, and D-dimer levels as significant independent predictors of necrotizing infections.

Inclusion criteria

• Diagnosis of venomous snake bites confirmed according to major international clinical guidelines and expert consensus.
• Availability of complete case data.
• Provision of written informed consent by the patients or their legal guardians.

Exclusion criteria

• Age less than 14 years.
• Long-term use of immunosuppressants or corticosteroids.
• Presence of concurrent immunodeficiency diseases (e.g., HIV positive).
• Severe malnutrition.
• Incomplete medical records.