Clinical and Hematological Parameters as the Predictors of Shock in Dengue Infection

Abstract

Dengue infection is one of the main health issues in the world and Asia has the highest incidence of dengue infection with most children aged 5-15 years affected. As World Health Organization guidelines recommend, the identification of warning signs at defervescence can detect patients who are at risk of progression to shock. This study aimed to determine the clinical and hematological parameters as the predictors of shock in dengue infection. This retrospective study collected medical records of pediatric patients suffering from dengue infection admitted to dr. Soediran Mangun Sumarso Regional Hospital in Wonogiri, Central Java in January-November 2016. Data was collected in December 2016. The studied predictor factors consisted of clinical and hematological parameters that represented the warning signs of dengue infection. Statistical analysis was performed using the logistic regression test. Of the 110 eligible subjects, 33 (30%) of them suffered from dengue shock syndrome. The multivariate analysis showed that gastrointestinal bleeding (OR=32.62), pleural effusion (OR=31.45), hematocrit >45% (OR=8.67), and thrombocytopenia ≤50,000/µL (OR=13) increased the risk of dengue shock syndrome. Clinical parameters as gastrointestinal bleeding and pleural effusion as well as laboratory parameters of hematocrit and thrombocytopenia became the predictors of shock in dengue infection.