ArticlePLoS neglected tropical diseases2022
A simple mortality risk prediction score for viper envenoming in India (VENOMS): A model development and validation study.
Article in PLoS neglected tropical diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 18 citations in OpenAlex.
- Adjunctive Varespladib after antivenom administration for snakebite: A phase II randomized clinical trial.PLoS neglected tropical diseases · 2026Trial
- Oral varespladib for the treatment of snakebite envenoming in India and the USA (BRAVO): a phase II randomised clinical trial.BMJ global health · 2024Trial
- Integrated computational investigation ofFrontiers in molecular biosciences · 2026Article
- Comparative Proteomics, Functional Characterization and Immunological Cross-Reactivity Studies on Russell's Viper Venom from Two Distinct Geographical Regions in South India.International journal of molecular sciences · 2025Article
- Handheld Point-of-Care Devices for Snakebite Coagulopathy: A Scoping Review.Thrombosis and haemostasis · 2025Article
- Using a Machine Learning Approach to Predict Snakebite Envenoming Outcomes Among Patients Attending the Snakebite Treatment and Research Hospital in Kaltungo, Northeastern Nigeria.Tropical medicine and infectious disease · 2025Article
- Capillary leak syndrome due to snakebite in the Amazon: case report.Revista peruana de medicina experimental y salud publica · 2025Article
- Systemic capillary leak syndrome.Nature reviews. Disease primers · 2024Review
- Hump-Nosed Pit Viper (Cells · 2024Article
- Article
- Viper Venom Phospholipase A2 Database: The Structural and Functional Anatomy of a Primary Toxin in Envenomation.Toxins · 2024Article
- Clinical Risk Factors Associated with Poor Outcomes in Snake Envenoming: A Narrative Review.Toxins · 2023Review
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5 authors at 4 institutions in 1 country.
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Abstract
backgroundSnakebite is a neglected problem with a high mortality in India. There are no simple clinical prognostic tools which can predict mortality in viper envenomings. We aimed to develop and validate a mortality-risk prediction score for patients of viper envenoming from Southern India.
methodsWe used clinical predictors from a prospective cohort of 248 patients with syndromic diagnosis of viper envenoming and had a positive 20-minute whole blood clotting test (WBCT 20) from a tertiary-care hospital in Puducherry, India. We applied multivariable logistic regression with backward elimination approach. External validation of this score was done among 140 patients from the same centre and its performance was assessed with concordance statistic and calibration plots.
findingsThe final model termed VENOMS from the term "Viper ENvenOming Mortality Score included 7 admission clinical parameters (recorded in the first 48 hours after bite): presence of overt bleeding manifestations, presence of capillary leak syndrome, haemoglobin <10 g/dL, bite to antivenom administration time > 6.5 h, systolic blood pressure < 100 mm Hg, urine output <20 mL/h in 24 h and female gender. The lowest possible VENOMS score of 0 predicted an in-hospital mortality risk of 0.06% while highest score of 12 predicted a mortality of 99.1%. The model had a concordance statistic of 0·86 (95% CI 0·79-0·94) in the validation cohort. Calibration plots indicated good agreement of predicted and observed outcomes.
conclusionsThe VENOMS score is a good predictor of the mortality in viper envenoming in southern India where Russell's viper envenoming burden is high. The score may have potential applications in triaging patients and guiding management after further validation.
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