A simple mortality risk prediction score for viper envenoming in India (VENOMS): A model development and validation study.

Autor: Maya Gopalakrishnan, Suman Saurabh, Pramod Sagar, Chanaveerappa Bammigatti, Tarun Kumar Dutta
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: PLoS Neglected Tropical Diseases, Vol 16, Iss 2, p e0010183 (2022)
Druh dokumentu: article
ISSN: 1935-2727
1935-2735
DOI: 10.1371/journal.pntd.0010183
Popis: 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 6.5 h, systolic blood pressure < 100 mm Hg, urine output 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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