Krait envenomation in Thailand

Figures & data

Table 1 Demographic data and characteristics of studied patients

Characteristics	Number (%)
Sex
Male	46 (59.0)
Female	32 (41.0)
Age, years	28 (1–76)
Bite site
Extremities	73 (93.6)
Other	5 (6.4)
Fang mark
Unidentified	12 (15.4)
Identified	66 (84.6)
Bite location
Indoor	23 (29.5)
Outdoor	55 (70.5)
Bite time
Day (6:00 AM to 6:00 PM)	21 (26.9)
Night (6:00 PM to 6:00 AM)	57 (73.1)
Season
Rainy	38 (48.7)
Winter	24 (30.8)
Summer	16 (20.5)

Note: Data are presented as median (range).

Table 2 Clinical manifestations beyond neurological effects (extra-neurological effects)

Clinical effects (number of cases recorded)	Number (%)
High blood pressure (n=46)	31 (67.4)
Tachycardia (n=47)	29 (61.7)
Hypokalemia (potassium of 2.4–3.4 mEq/L) (n=38)	21 (55.3)
Hyponatremia (sodium of 117–130 mEq/L) (n=34)	6 (17.6)
Bradycardia (n=47)	4 (8.5)
Abdominal pain (n=62)	3 (4.8)

Table 3 Clinical course and treatment of all patients bitten by MK and BK

Clinical course and treatment	All patients (n=78)	Patients bitten by MK (n=68)	Patients bitten by BK (n=9)
Clinical course
Onset of neurological symptoms after bite, hours	3 (0.5–8)	1 (0.5–8)	3 (0.5–7)
Time to antivenom treatment after bite, hours	5 (0.5–64)	5 (0.5–64)	4 (3–12)
Amount of antivenom, vials	15 (3–50)	15 (3–50)	9 (3–20)
Duration of intubation, days	6 (1–37)	6 (1–37)	6 (1–15)
Hospital stay, days	7 (1–66)	8 (1–66)	2 (1–20)
Dry bites (% of patients)	9 (11.5)	6 (8.8)	3 (33.3)
Treatment
Endotracheal intubation with ventilator support	59 (75.6)	54 (79.4)	5 (55.6)
Antivenom use	67 (85.9)	61 (89.7)	6 (66.7)
Antivenom type
Monovalent	51 (76.1)	47 (77.0)	4 (66.7)
Polyvalent neurotoxin	7 (10.4)	6 (9.8)	1 (16.7)
Monovalent and polyvalent neurotoxin	4 (6.0)	3 (4.9)	1 (16.7)
Monovalent and cobra antivenom	5 (7.5)	5 (8.2)	–
Allergic reaction to antivenoms (% of patients who received antivenom)	4 (6.0)	3 (4.9)	1 (16.7)
Development of complications during hospitalization	25 (32.1)	24 (35.3)	1 (11.1)
Mortality	5 (6.4)	5 (7.4)	0 (0.0)

Note: Data are presented as median (range) or n (%).

Abbreviations: BK, banded krait; MK, Malayan krait.

Table 4 Comparison of clinical manifestations and laboratory findings between patients who survived and those who died

Clinical manifestations and laboratory findings	Survived	Died	P-value
Age, years (n=78)	73 (1–76)	5 (6–47)	0.520
Onset of neurological symptoms, hours (n=64)	3 (0.5–8)	1 (0.5–4)	0.193
Time to application of antivenom, hours (n=66)	5 (1–64)	2.5 (0.5–24)	0.143
Amount of antivenom, vials (n=67)	15 (3–50)	20 (3–30)	0.313
Duration of intubation, days (n=59)	6 (1–24)	6 (3–60)	0.477
Tachycardia/bradycardia (n=47)	30 (68.2)	3 (100)	0.544
High blood pressure (n=46)	29 (67.4)	2 (66.7)	1.000
Hypokalemia (n=38)	19 (52.8)	2 (100)	0.492
Hyponatremia (n=34)	6 (17.6)	0 (0.0)	1.000
In-hospital complications (n=78)	20 (27.4)	5 (100)	0.003a

Notes: Data are presented as median (range) or n (%).

a Statistically significant.