Early hematological parameters as predictors for outcomes in children with dengue in northern India: A retrospective analysis

Sociedade Brasileira de Medicina Tropical. Revista

article

Sumi Nandwani¹  Bhanu Kiran Bhakhri²  Nupur Singh²  Ruchi Rai³  Dharmender Kumar Singh² 

[1] Superspecialty Pediatric Hospital & Postgraduate Teaching Institute, Department of Microbiology;Superspecialty Pediatric Hospital & Postgraduate Teaching Institute, Department of Pediatrics;Superspecialty Pediatric Hospital & Postgraduate Teaching Institute, Department of Neonatology

关键词: Hemorrhagic fever;    Leucocyte count;    Mean platelet volume;    Platelet count;    Mortality predictors;   

DOI  :  10.1590/0037-8682-0519-2020

学科分类：农业科学（综合）

来源: Sociedade Brasileira de Medicina Tropical

【 摘 要 】

Introduction: Dengue presents with a variable clinical course, ranging from mild illness to potentially fatal hemorrhage and shock. We aimed to evaluate the capabilities of various hematological parameters observed early in the course of illness for predicting the clinical outcomes of illness. Methods: We retrospectively analyzed the records of children admitted in the pediatric inpatient services of the institute with dengue between 2017 and 2019. We determined the relationships between the hematological parameters observed during the first evaluation and the various clinical outcomes. Results: We evaluated data from 613 patients (age range, 26 days to 17 years). Of these, 29.85% exhibited fever with warning signs, and 8.97% had severe dengue. Lower values of hemoglobin, platelet count, mean corpuscular volume, mean corpuscular hemoglobin concentration, and mean platelet volume, and higher values of total leukocyte count (TLC), hematocrit, and red cell distribution width variably correlated with numerous clinical outcomes—duration of hospital stay, development of complications, requirement of blood component transfusion, inotropic support, and mortality. Among the parameters, TLC ≥20,000/mL and initial platelet count ≤20,000/mL significantly associated with mortality, with odds ratios (95% confidence interval) of 11.81 (4.21–33.80) and 5.53 (1.90–16.09), respectively. Conclusions: Hematological parameters observed early during dengue infection may predict its clinical outcomes in infected children. Initial high TLC and low platelet count are potential predictors of fatal outcomes in the course of disease.

【 授权许可】

CC BY