Epidemiological Study and Physiological Analysis of Snakebite Envenoming in China Northern Guangxi Zhuang Autonomous Region-a Retrospective Study

Abstract

Background Snakebite causing huge social costs worldwide. However, no systematic report of snake injuries in China Northern Guangxi Zhuang Autonomous Region until now. In this study, the details of patients with snake bites were retrospectively retrieved and reviewed. Details regarding age, gender, site of snake bites, consciousness, outcome and clinical features at the time of presentation to the hospital. Methods Data were extracted from the emergency department (2019-2021), epidemiological study and physiological analysis were performed. Results Our data showed that the majority of the bites were from Deinagkistrodon acutus(Da) and Protobothrops mucrosquamatus(Pm), respectively, accounting for 42.37% and 33.33%. 40.11% of snakebites occur in fields, 37.85% in areas neighboring houses, and 14.69% in mountains. Most bite victims were between 50 -70 years old (52.54%). The mean age was 57.32±15.12 years. There were 120 (67.80%) male victims, while 57 (32.20%) were females. For 93.22% of the patients, the site of bite was in the lower limbs, 6.21% in upper limbs and in 0.56% cases, it was in the head region. In terms of blood coagulation function, 69.33% (Da) and 91.53% (Pm) patients had normal Prothrombin Time (PT). A significant number of patients (30.66%) with Da bites had increased Prothrombin Time, while Pm only caused 8.47% of the individuals to have such an effect. The influence of Da and Pm bites on White Blood Cells (WBC) count showed an upward trend, with percentages of 41.33% and 61.02%, respectively. A similar trend was observed for neutrophils (48%/61.02%). The venom of both the species had similar effects on K⁺, Na⁺, Ca²⁺and Mg²⁺ (Normal rate (Da/Pm): 72%/71.19%, 100%/96.61%, 84%/83.05%, 68%/66.10%) in vivo. CreatineKinase-MB (CK-M b), Aspartate aminotransferase (AST) level in patients with snake injuries were the most abnormal (Normal rate (Da/Pm): 73.33%/62.71%), while the impact on Alanine aminotransferase (ALT), Lactate dehydrogenase (LDH), and albumin was relatively smaller (Normal rate (Da/Pm): 86.67%/91.53%, 90.67%/83.05%, 90.67%/83.05%). Conclusions The majority of the snakebites in China Northern Guangxi Zhuang Autonomous Region were from Deinagkistrodon acutus(Da) and Protobothrops mucrosquamatus(Pm), mostly occurs in fields/neighboring houses/ mountains. Most bite victims were between 50-70 years old. Da and Pm bites showed marked physiological variation, the treatment and monitoring after snakebites should be comprehensive and personalized.