Green Pit Viper Envenomations in Bangkok: A Comparison of Follow-Up Compliance and Clinical Outcomes in Older and Younger Adults

Toxins (Basel). 2022 Dec 10;14(12):869. doi: 10.3390/toxins14120869.

Abstract

We compared older and younger adults envenomated by the green pit viper (GPV) with regard to the following: follow-up compliance, elapsed time between envenomation and emergency department (ED) visit, and clinical/treatment outcomes. This was a two-site retrospective cohort study. We searched hospital electronic medical databases between January 2011 and December 2021. Patients aged 15 and above were eligible if they had a history of snakebite and had at least two VCT and/or platelet count results in their medical records. After the search, 1550 medical records were reviewed and 760 cases were found to be eligible for analysis. In total, 205 cases (27.0%) were ≥60 years old. The median ages in the younger and older groups were 40 (26-51) and 68 (64-75) years, respectively. The median elapsed times from bite to the ED were 47 (30-118) vs. 69 (35-150) min (p-value = 0.001). Overall, 91.3% of all cases were managed as out-patient cases and were eligible for follow-up appointments. The rate of out-patient follow-up at 72 ± 12 h in the older patients was significantly higher (43.2%) than in the younger adult patients (32.4%) (p-value = 0.01). Regarding the clinical/treatment outcomes, the rates of coagulopathy, antivenom administration, and hospital admission were not statistically different between both groups.

Keywords: Trimeresurus albolabris; Trimeresurus macrops; aging; coagulopathy; elderly; morbidity; mortality; senior; snakebite; thrombocytopenia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antivenins / therapeutic use
  • Crotalid Venoms* / therapeutic use
  • Follow-Up Studies
  • Retrospective Studies
  • Snake Bites* / drug therapy
  • Snake Bites* / epidemiology
  • Thailand
  • Trimeresurus*

Substances

  • Crotalid Venoms
  • Antivenins

Grants and funding

This study was funded by the Navamindradhiraj University Research Funds.