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

作者：Suwarto Suhendro; Nainggolan Leonard; Sinto Robert; Effendi Bonita; Ibrahim Eppy; Suryamin Maulana; Sasmono R Tedjo^*

来源：BMC Infectious Diseases, 2016, 16(1): 322.

DOI：10.1186/s12879-016-1671-3

• Albumin
• Ascites
• AST ratio
• Dengue score
• Hematocrit
• Platelet
• Pleural effusion

Background: There 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.
Methods: A 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.
Results: A 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/mu L 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.
Conclusions: We 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.

• 出版日期2016-7-8