Background
: Most of the Poisonous snakebites occurs during summer time and in rural area. Mortality from poisonous snakebite is low but some develop serious complications or even die. Because many authors have different opinions how to treat snakebites, especially regarding the use of antivenin, we have conducted this study in order to review the indicators that can predict the severity of snakebites, and to examine to effectiveness of antivenin.

Methods : From January, 1990 through December, 1994, 178 patients were admitted for treatment of poisonous snakebite. Reviewing theses patients' medical records, incidence of occurrence in accorda-nce with sex, age, and season, local and systemic symptoms and signs, and abnormal laboratory findings, were investigated. Seven randomly seleced prognostic indicators-patient age and sex, bitten month, time of day bitten, bitten site, time of arrival at hospital after biting, and use of constricting band-were used to compare patients' severity. In addition, patients' severity and period of hospotaliza-tion with respect to patients who received antivenin and those who did not were also compared.

Results : Of the 178 patients, the number of female patients was larger than that of male patients, in the ratio 1.5 to 1.0. Most patients were in their 50s, and most bites occurred during. July and August. Pain around the bitten area was found in 172 patients(96.6%), and proved the most common local symptom. Of systemic symptoms, dizziness was the most common, found in 64 patients(36.0%). Of obnormal laboratory findings, leukocytosis was most frequently encountered, affecting 55 patients(30.9%). In analyzing correlation between prognostic indicators and severity, patient age(P<0.01) showed significant differences. In addition, the group which received antivenin showed significant differences with regard to severity similarly showed significant differences with regard to period of hospitalization(P<0.05 for minimal and severe cases; P<0.1 for moderate cases).

Conclusion : Older patients, and those bitten in the upper limbs rather than in the lower limbs are predicted to have greater severity. Thus, such patients need more intensive observation and treatment. All snaka-bitten victims must be transferred to a hospital as rapidly as possile; and administration of antivenin should be actively considered for those who show symptoms of envenoma-tion.