Gopalakrishnan et al reported the VENOMS score to describe viper bites in India. This can help to identify a patient who may require more aggressive management. The authors are from the All India Institute of Medial Sciences, Madras edical Mission, Jawaharlal Institute of Medical Education and Mahatma Gandhi Medical College and Research Institute in India.
VENOMS is derived from Viper ENvenOming Mortality Score.
Patient selection: viper bite
Parameters:
(1) sex of the patient
(2) capillary leak syndrome (CLS)
(3) time interval between viper bite and antivenom administration in hours
(4) bleeding
(5) hemoglobin in g/dL
(6) urine output in mL per hour
(7) systolic blood pressure
|
Parameter
|
Finding
|
Points
|
Beta
|
|
sex
|
male
|
0
|
0
|
|
|
female
|
1
|
0.903
|
|
capillary leak syndrome
|
no
|
0
|
0
|
|
|
yes
|
2
|
2.178
|
|
time to antivenom
|
<= 6.5 hours
|
0
|
0
|
|
|
> 6.5 hours
|
1
|
0.660
|
|
bleeding
|
no
|
0
|
0
|
|
|
yes
|
3
|
2.848
|
|
hemoglobin
|
>= 10 g/dL
|
0
|
0
|
|
|
< 10 g/dL
|
1
|
0.806
|
|
urine output
|
>= 20 mL per hour
|
0
|
0
|
|
|
< 20 mL per hour
|
2
|
2.173
|
|
systolic blood pressure
|
>= 100 mm Hg
|
0
|
0
|
|
|
< 100 mm Hg
|
2
|
1.888
|
total score =
= SUM(points for all of the parameters)
value of X =
= SUM(beta coefficients) - 7.276
probability of mortality =
= 1 / (1 + EXP((-1) * X))
Interpretation:
• minimum score: 0
• maximum score: 12
• The higher the score the greater the risk of mortality.
Performance:
• The area under the ROC curve is 0.95.
