Dengue score: a proposed diagnostic predictor for pleural effusion and/or ascites in adults with dengue infection

BMC Infectious Diseases

Research Article

Bonita Effendi¹  Maulana Suryamin²  Eppy Ibrahim²  Leonard Nainggolan³  Robert Sinto³  Suhendro Suwarto³  R. Tedjo Sasmono⁴ 

[1] Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Jakarta, Indonesia;Department of Internal Medicine, Persahabatan Hospital, Jakarta, Indonesia;Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia;Eijkman Institute of Molecular Biology, Jl. Diponegoro 69, 10430, Jakarta, Indonesia;

关键词: Albumin;    Ascites;    AST ratio;    Dengue score;    Hematocrit;    Platelet;    Pleural effusion;   

DOI  :  10.1186/s12879-016-1671-3

 received in 2016-01-05, accepted in 2016-06-10,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThere are several limitations in diagnosing plasma leakage using the World Health Organization (WHO) guidelines of dengue hemorrhagic fever. We conducted a study to develop a dengue scoring system to predict pleural effusion and/or ascites using routine laboratory parameters.MethodsA prospective observational study was carried out at Cipto Mangunkusumo Hospital and Persahabatan Hospital, Jakarta, Indonesia. Dengue-infected adults admitted on the third febrile day from March, 2010 through August, 2015 were included in the study. A multivariate analysis was conducted to determine the independent diagnostic predictors of pleural effusion and/or ascites and to convert the prediction model into a scoring system.ResultsA total of 172 dengue-infected adults were enrolled in the study. Of the 172 patients, 101 (58.7 %) developed pleural effusion and/or ascites. A multivariate analysis was conducted to determine the independent diagnostic predictors of pleural effusion and/or ascites in dengue-infected adults. The predictors were scored based on the following calculations: hemoconcentration ≥15.1 % had a score of 1 (OR, 3.11; 95 % CI, 1.41–6.88), lowest albumin concentration at critical phase ≤3.49 mg/dL had a score of 1 (OR, 4.48; 95 % CI, 1.87–10.77), lowest platelet count ≤49,500/μL had a score of 1 (OR, 3.62; 95 % CI, 1.55–8.49), and elevated ratio of AST ≥2.51 had a score of 1 (OR 2.67; 95 % CI, 1.19–5.97). At a cut off of ≥ 2, the Dengue Score predicted pleural effusion and/or ascites diagnosis with positive predictive value of 79.21 % and negative predictive value of 74.63 %. This prediction model is suitable for calibration and good discrimination.ConclusionsWe have developed a Dengue Score that could be used to identify pleural effusion and/or ascites and might be useful to stratify dengue-infected patients at risk for developing severe dengue.

【 授权许可】

CC BY   
© The Author(s). 2016