{
  "abstract": "Background\n\nSnakebite envenomation is a global public health concern with high mortality and morbidity. Given the highly heterogeneous clinical progression and the potential for rapid deterioration in severe cases, early risk stratification is crucial for improving outcomes. This study aimed to develop a nomogram based on simple laboratory indicators to assist primary care clinicians in rapidly identifying high-risk patients, thereby optimizing interventions and reducing mortality and healthcare burden.Methods\n\nWe conducted a retrospective analysis of 10,505 snakebite envenomation cases admitted to the Medical Laboratory Center of Shaanxi Provincial People's Hospital between March 2014 and October 2025. After applying strict eligibility criteria, 2762 patients were randomly assigned to a training cohort (n=2072) and a validation cohort (n=690) at a 3:1 ratio. LASSO regression and multivariate logistic regression were used to identify independent risk factors for severe complications, which were then incorporated into a nomogram. Model performance was assessed by the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA).Results\n\nOf the 2762 patients, 64 (2.32%) developed severe complications, most commonly acute myocardial injury, acute liver injury, coagulopathy, and multiple organ dysfunction; the majority presented with two or more. Time from bite to presentation (OR=1.017, 95% CI 1.005-1.027), white blood cell count (OR=1.116, 95% CI 1.043-1.190), and prothrombin time (OR=1.103, 95% CI 1.011-1.203) were identified as independent predictors. The nomogram demonstrated strong discrimination, with AUCs of 0.812 (95% CI 0.741-0.882) and 0.839 (95% CI 0.734-0.945) in the training and validation cohorts, respectively. Calibration was excellent (Hosmer-Lemeshow P>0.05), and decision curve analysis confirmed net clinical benefit.Conclusion\n\nThis readily accessible nomogram, based on time to presentation, WBC, and PT, demonstrates strong predictive performance, high operability, and clinical accessibility, facilitating early identification of high-risk patients and optimization of treatment decisions.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Clinical Laboratory, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, People's Republic of China.",
    "Department of Burns and Plastic Surgery, Fourth Medical Centre of Chinese PLA General Hospital, Beijing, People's Republic of China.",
    "Medical College, Yan' an University, Yan'an, Shaanxi, People's Republic of China.",
    "Translational Medicine Centre of Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, People's Republic of China.",
    "Second Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, People's Republic of China.",
    "Department of Critical Care Medicine, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, People's Republic of China.",
    "Medical Administration Department of Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, People's Republic of China.",
    "Department of Information, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, People's Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jiahao Guan",
      "orcid": "0009-0004-2844-5084"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhenkai Zhao"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Fei Wang"
    },
    {
      "affs": [
        3
      ],
      "name": "Wenli Zhang"
    },
    {
      "affs": [
        4
      ],
      "name": "Xianglong Duan"
    },
    {
      "affs": [
        0
      ],
      "name": "Lixia Zhang"
    },
    {
      "affs": [
        5
      ],
      "name": "Zhenguo Liu"
    },
    {
      "affs": [
        6
      ],
      "name": "Liang Shan"
    },
    {
      "affs": [
        7
      ],
      "name": "Duo Dai"
    },
    {
      "affs": [
        3
      ],
      "name": "Zifan Lu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/eb8gyedtewh3e.bib",
  "cited_by": 0,
  "doi": "10.2147/ijgm.s640320",
  "fulltext_url": "https://europepmc.org/articles/PMC13695929",
  "id": "eb8gyedtewh3e",
  "issns": [
    "1178-7074"
  ],
  "landing_url": "https://europepmc.org/article/MED/42928901",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "1311|Venomous Animal Envenomation and Studies"
    ]
  ],
  "openalex": "W7223085494",
  "pdf_url": "https://europepmc.org/articles/PMC13695929?pdf=render",
  "pmcid": "PMC13695929",
  "pmid": "42928901",
  "published": "2026-10-21",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/eb8gyedtewh3e.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42928901",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42928901"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:1311|Venomous Animal Envenomation and Studies",
      "subfield": "genetics-genomics"
    }
  ],
  "title": "Development and Internal Validation of a Nomogram for Predicting Severe Complications After Snakebite: A Retrospective Cohort Study.",
  "title_text": "Development and Internal Validation of a Nomogram for Predicting Severe Complications After Snakebite: A Retrospective Cohort Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:18Z",
  "url": "https://research.draconitic.com/paper/eb8gyedtewh3e",
  "venue": "International journal of general medicine",
  "versions": []
}