A five-year retrospective review of snakebite patients admitted to a tertiary university hospital in Malaysia

Keng Sheng Chew,Nik Hisamuddin Nik Abdul Rahman,Rashidi Ahmad,Heng Wei Khor

doi:10.1186/1865-1380-4-41

Keng Sheng Chew, Nik Hisamuddin Nik Abdul Rahman + Show 2 more

Open Access

https://doi.org/10.1186/1865-1380-4-41

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Abstract

BackgroundAlthough the majority of the snakebite cases in Malaysia are due to non-venomous snakes, venomous bites cause significant morbidity and mortality if treatment measures, especially ant-venom therapy, are delayed.MethodsTo determine the demographic characteristics, we conducted a retrospective study on all snakebite patients admitted to the Emergency Department of Hospital Universiti Sains Malaysia (HUSM) from January 2006 to December 2010.ResultsIn the majority of the 260 cases that we found (138 cases or 52.9%), the snake species was unidentified. The most common venomous snakebites among the identified species were caused by cobras (52 cases or 20%). Cobra bites are significantly more likely to result in severe envenomation compared to non-cobra bites. Post hoc analysis also showed that cobra bite patients are significantly less likely to have complete recovery than non-cobra bite patients (48 cases, 75.0% vs. 53 cases, 94.6%; p = 0.003) and more likely to result in local gangrene (11 cases, 17.2% vs. 3 cases, 5.4%; p = 0.044).ConclusionCobra bites are significantly more likely to result in severe envenomation needing anti-venom administration and more likely to result in local gangrene, and the patients are significantly less likely to have complete recovery than those with non-cobra bites.

Highlights

As early as 1963, it was shown that the majority (74.0%) of snakebite incidents in Malaysia occurred in the four northern states of Peninsular Malaysia [1]
Did we find that cobra bites made up the majority of the identified venomous snakebites in our study, but cobra bites were more likely to result in severe envenomation compared to other species
In view of the great importance of anti-venom in cases of moderate to severe envenomation, greater emphasis should be placed on patient education

Summary

Introduction

As early as 1963, it was shown that the majority (74.0%) of snakebite incidents in Malaysia occurred in the four northern states of Peninsular Malaysia [1]. Most snakes in Malaysia are non-venomous and are relatively harmless to humans. About 17 out of the 105 strict land snakes in Malaysia are venomous [2]. Most bites are dry bites because they are defensive [1] While this may be true, the more challenging problem is accurate species identification [3] by the Venomous snakes in Malaysia can be divided into three main groups - two groups of land snakes and one of sea snakes. All 22 species of sea snakes in Malaysia are considered venomous [2]. The majority of the snakebite cases in Malaysia are due to non-venomous snakes, venomous bites cause significant morbidity and mortality if treatment measures, especially ant-venom therapy, are delayed

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