Bamboo snake (Trimeresurus albolabris) bite in Hong Kong and itprognostic factors for local complications with surgical interventioncoagulopathy and thrombocytopenia

Abstract

Introduction: Bamboo snake bite accounts for the majority of venomous snake bites in Hong Kong. The objectives of this study were to evaluate the clinical features and outcomes of Bamboo snake bite in Hong Kong and to identify its prognostic factors for local complications requiring surgical intervention, coagulopathy and thrombocytopenia. Methods: It was a retrospective cohort study conducted in a regional hospital of Hong Kong from 1st January 2001 to 31st December 2015. Results: Sixty-three subjects were in the final analyses. The mean age was 60 years old. The incidences of swelling, local bruises, blistering, regional lymphadenopathy and local necrosis were 90.5%, 33.3%, 6.3%, 1.6% and 3.2% respectively. The incidences of local complications with surgical intervention, coagulopathy and thrombocytopenia were 6.3%, 13% and 13% respectively. Univariate analysis showed only local necrosis (p=0.003) was significantly associated with local complications with surgical intervention; and only cardiovascular disturbance due to snakebite envenomation (p=0.002) was significantly associated with coagulopathy; and no significantly associated factor was found for thrombocytopenia. There were no case with systemic bleeding and death after Bamboo snake bite. There was no case with allergic reaction after the use of antivenom. Conclusions: Local necrosis is significantly associated with surgical intervention. Cardiovascular disturbance is significantly associated with coagulopathy. Allergic reaction after the use of antivenom is rare in Hong Kong.