Consideration of Factors associated with Complications and Systemic Symptoms of Snake Bites

ABSTRACT

PURPOSE: Venomous snakebite is an important medical emergency in Korea, but the factors affecting outcomes are unclear. METHODS: We conducted an 8-year retrospective study of 169 snake bite patients who visited the emergency departments of Keimyung University at Dongsan Medical Center between January, 2000, and December, 2007. Patients were divided by systemic symptoms and complications (group 1) or local symptoms only (group 2). We compared the general characteristics and clinical and laboratory findings of the two groups. RESULTS: The male to female ratio was 1.19. The most common systemic symptom was dizziness (7.6%), and the most common complication was rhabdomyolysis (23.6%). Distal bite sites (finger, toe) in group 1 occurred in 20 (35.7%) cases, and proximal (hand, foot, ankle, arm, calf, perianal area) in 36 (64.3%) cases (p<0.05). The median interval from envenomation to hospital visit was 6.0 (0.3-96.0) h in group 1, which was longer than group 2 (p<0.05). Among 33 (19.5%) patients with local effect scores of 9~16, 25 (75.8%) patients had systemic symptoms and complications. The local effect scores and the interval from bite to antivenin treatment in the hospital were significant risk factors for systemic symptoms and complications in logistic regression analysis. CONCLUSION: Snakebite poisoning is an emergency and we must evaluate risk factors to prevent the development of serious complications.