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

To 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.In 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).Cobra 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.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]. Fortunately, most snakes in Malaysia are non-venomous and are relatively harmless to humans. Only about 17 out of the 105 strict land snakes in Malaysia are venomous [2].In fact, even bites of venomous snakes are often not life threatening for humans unless a sufficient amount of venom is injected at the time of the bite. In fact, most bites are dry bites because they are defensive [1]. Nonetheless, while this may be true, the more challenging problem is accurate species identification [3] by the witnesses. It is often difficult to even identify whether a snake is venomous or not, let alone identify its exact species [2].Venomous snakes in Malaysia can be divided into three main groups - two groups of land snakes and one of sea snakes. The two main groups