NCT04520282

Brief Summary

Background Novelty The global assays of coagulation, namely the viscoelastometric tests and clot waveform has never been studied in detail before in snakebite victims. The pathophysiology of VICC including specific factor deficiencies and serial trend in blood cell indices amongst various hematotoxic snakebite in the region is not known. No Indian study to date has systematically examined the changes in early laboratory tests results in envenomed and non envenomed snakebite victims.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
96

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Mar 2022

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 31, 2020

Completed
3 months until next milestone

First Posted

Study publicly available on registry

August 20, 2020

Completed
1.6 years until next milestone

Study Start

First participant enrolled

March 15, 2022

Completed
1.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 31, 2023

Completed
9 days until next milestone

Study Completion

Last participant's last visit for all outcomes

August 9, 2023

Completed
Last Updated

March 7, 2024

Status Verified

March 1, 2024

Enrollment Period

1.4 years

First QC Date

May 31, 2020

Last Update Submit

March 6, 2024

Conditions

Keywords

global coagulation assayhemostatic variablescoagulopathyVICCDICVenom induced consumptive coagulopathyDisseminated intravascular coagulationROTEMCWAclot waveform analysis20'WBCTClotting timethromboelastometryviscoelastometryblood cell indicessnakebitehematotoxic

Outcome Measures

Primary Outcomes (3)

  • To study the serial change in CT of snakebite victims

    Change from baseline (sample taken at admission) for clotting time would be recorded in minutes and seconds assessed at 1 hour (post admission), 1 hour 30 mins (post admission), 3 hours (post admission), 6 hours (post bite), 6 hours post antivenom, 6 hours after blood products or 12 hours after antivenom and at discharge or at 30 days (whichever is earlier)

    up to 30 days

  • To study the serial change in fibrinogen levels of snakebite victims

    The change in fibrinogen levels from baseline (sample taken at admission, 0 hour), 6 hour post bite, 6 hours post antivenom,12 hours post antivenom, 6 hours after blood products and at discharge or at 30 days (whichever occurs earlier), measured in weight per volume (milligram per decilitre).

    up to 30 days

  • To study the serial change in D dimer levels of snakebite victims

    The change D dimer from baseline (sample taken at admission, 0 hour), 6 hour post bite, 6 hours post antivenom,12 hours post antivenom, 6 hours after blood products and at discharge or at 30 days (whichever occurs earlier) measured in weight per volume ( micrograms per decilitre respectively).

    up to 30 days

Secondary Outcomes (6)

  • Diagnostic accuracy of Clotting Time in detecting coagulopathy

    48 hours

  • Diagnostic accuracy of 20'WBCT, MLW, Delayed reading of 20'WBCT in detecting coagulopathy

    48 hours

  • Change in coagulopathy in snakebite victims, after antivenom administration as measured by normalisation of the bedside coagulation tests.

    48 hours

  • Change in coagulopathy in snakebite victims, after antivenom administration as measured by normalisation conventional coagulation tests

    48 hours

  • To study the serial change in PT and aPTT-clot waveform of snakebite victims

    up to 7 days

  • +1 more secondary outcomes

Other Outcomes (11)

  • Time to envenomation in hematotoxic snakebites in the region

    7 days

  • Time to envenomation in Russells viper snake bite in the region

    48 hours

  • Time to envenomation in pitviper (crotaline) snake bite in the region

    48 hours

  • +8 more other outcomes

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

All patients with history suggestive of snakebite presenting within 6 hours of snakebite and providing a written informed consent and/or assent would be included in the study Definitions: 'Snakebite' OR 'History suggestive of snakebite' would be defined as, patients or their bystander claiming in sound mind not and not under the influence of any inebriants, to have witnessed being bitten by a snake, OR, patient with clinical features of snakebite as suspected by the clinician on floor

You may qualify if:

  • All patients with history suggestive of snakebite presenting within 6 hours of snakebite AND
  • All providing a written informed consent and/or assent

You may not qualify if:

  • All patients of stings or bites other than snakes
  • All patients who received antivenom or blood products at another institute
  • All patients with known hematological malignancies, coagulation disorders, chronic liver or renal failure.
  • All patients known to be on warfarin, heparin or any newer oral or injectable anticoagulants
  • All withdrawing a consent later on, or withdrawing assent later on-

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Jubilee Mission Medical College and Research Institute

Thrissur, Kerala, 680005, India

Location

Related Publications (1)

  • Abraham SV, Rafi AM, Krishnan SV, Palatty BU, Innah SJ, Johny J, Varghese S. Utility of Clot Waveform Analysis in Russell's Viper Bite Victims with Hematotoxicity. J Emerg Trauma Shock. 2018 Jul-Sep;11(3):211-216. doi: 10.4103/JETS.JETS_43_17.

    PMID: 30429630BACKGROUND

Biospecimen

Retention: SAMPLES WITH DNA

Blood sample

MeSH Terms

Conditions

Snake BitesDisseminated Intravascular CoagulationHemostatic Disorders

Condition Hierarchy (Ancestors)

Bites and StingsPoisoningChemically-Induced DisordersWounds and InjuriesBlood Coagulation DisordersHematologic DiseasesHemic and Lymphatic DiseasesHemorrhagic DisordersThrombophiliaVascular DiseasesCardiovascular Diseases

Study Officials

  • Siju V Abraham, M D

    Jubilee Mission Medical College and Research Institute

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

May 31, 2020

First Posted

August 20, 2020

Study Start

March 15, 2022

Primary Completion

July 31, 2023

Study Completion

August 9, 2023

Last Updated

March 7, 2024

Record last verified: 2024-03

Locations