Abstract
BACKGROUND: Snakebite envenoming remains poorly understood in terms of long-term health-related quality of life (HRQoL), particularly in China where standardized assessments are lacking. This study is the first to comprehensively evaluate HRQoL impairments in discharged snakebite patients using the EuroQol 5-Dimension 5-Level (EQ-5D-5 L) instrument in China, addressing a critical methodological gap. METHODS: A multicenter cross-sectional study enrolled 6,528 snakebite patients. HRQoL was assessed via EQ-5D-5 L (Chinese value set) and customized surveys. Generalized linear models and XGBoost machine learning identified predictors. RESULTS: The mean utility score (0.76 ± 0.27) was significantly lower than China's general population (0.95). Pain/discomfort (53.6%) and mobility impairment (45.4%) were most prevalent. Machine learning revealed key predictors: post-traumatic stress disorder (PTSD, 34.5%) > number of snakebites (11.7%) > time of arrival at medical institutions (7.9%) > depression (7.8%) > marriage (6.5%). CONCLUSIONS: This study provides the first EQ-5D-5 L-based quantification of the significant HRQoL burden among snakebite survivors in China. Physical impairments predominantly manifest in the mobility and pain/discomfort dimensions, while mental health disorders constitute the primary driver of long-term HRQoL deterioration. Crucially, we identified PTSD, time to medical facility, and bite frequency as modifiable predictors, evidencing their relevance for snakebite prevention and control strategies.