ArticleToxicon: X2026
Admission point-of-care D-dimer for identifying haemostatic envenomation after snakebite: A prospective observational study.
Article in Toxicon: X, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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6 authors.
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Abstract
Haemostatic envenomation (HE) - comprising venom-induced coagulopathy, thrombocytopenia, and systemic bleeding - is the principal determinant of snakebite morbidity in South Asia. Conventional coagulation tests lack sensitivity for early haemostatic activation; D-dimer has been proposed as a rapid triage biomarker, but data from Indian emergency settings are lacking. We conducted a prospective diagnostic accuracy study (JMMC&RI, Thrissur, Kerala; March-December 2022; n = 96 consecutive snakebite patients). The primary aim was to evaluate the diagnostic accuracy of admission point of care D-dimer for identifying HE. Secondary aims were to compare its performance with standard coagulation tests and to evaluate it against the broader composite outcome - clinically significant envenomation (CSE). HE was defined as modified Lee-White clotting time (MLW) ≥15 min, failed 20-min whole-blood clotting test (20WBCT), INR ≥1.4, fibrinogen <100 mg/dL, platelet count <100 × 10
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