title: A five-year retrospective review of snakebite patients admitted to a tertiary university hospital in Malaysia.
abstract: BACKGROUND
  Although the majority of the snakebite cases in Malaysia are due to non-venomous snakes, venomous bites cause significant morbidity and mortality if treatment measures, especially ant-venom therapy, are delayed.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Emergency Medicine Department, School of Medical Sciences, 16150 Kubang Kerian, Universiti Sains Malaysia, Penang, Malaysia. cksheng74@yahoo.com.
authors.forename: Keng Sheng
authors.initials: KS
authors.lastname: Chew
authors.forename: Heng Wei
authors.initials: HW
authors.lastname: Khor
authors.forename: Rashidi
authors.initials: R
authors.lastname: Ahmad
authors.forename: Nik Hisamuddin Nik Abdul
authors.initials: NH
authors.lastname: Rahman