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Predictors of spontaneous bleeding in Dengue
So Shivbalan1, K Anandnathan, S Balasubramanian
1Kanchi Kamakoti Childs Trust Hospital, Nungambakkam, Chennai, India. shivbalan1@rediffmail.com
Indian Journal of Pediatrics
|February 26, 2004
Summary
Predicting spontaneous bleeding in Dengue illness is crucial. A combination of biphasic fever, hemoconcentration, low platelet count, and elevated ALT can help identify children at risk.
Area of Science:
- Pediatric Infectious Diseases
- Hematology
- Virology
Background:
- Dengue virus infection is a significant global health concern, particularly in infants and children.
- Spontaneous bleeding manifestations complicate Dengue illness, necessitating early identification of at-risk individuals.
Purpose of the Study:
- To determine the key predictive factors for spontaneous bleeding in pediatric Dengue cases.
- To develop a predictive model for identifying children with Dengue at high risk of bleeding.
Main Methods:
- A comparative study involving 60 Dengue patients with spontaneous bleeding and 72 without.
- Analysis of clinical and laboratory parameters using univariate and logistic regression.
Main Results:
- Prothrombin time was significantly abnormal only in patients with spontaneous bleeding.
- A combination of biphasic fever, hemoconcentration, platelet count <50,000/mm³, and elevated ALT demonstrated predictive value.
Conclusions:
- The identified combination of factors (biphasic fever, hemoconcentration, low platelets, elevated ALT) offers a predictive tool for spontaneous bleeding in Dengue.
- This model achieved a sensitivity of 79.2% and specificity of 64.7%, with a positive predictive value of 70% and negative predictive value of 75%.