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Risk factors of dengue shock syndrome in children

Vijay Gupta1, Tribhuvan Pal Yadav, Ravindra Mohan Pandey

  • 1Department of Pediatrics, PGIMER and associated Dr Ram Manohar Lohia Hospital, New Delhi, India. yzaygupta@gmail.com

Journal of Tropical Pediatrics
|March 4, 2011
PubMed

Insights

Pediatric dengue hemorrhagic fever (DHF) patients over 5 years old with spontaneous bleeding, enlarged liver, or fluid buildup are at higher risk for developing dengue shock syndrome (DSS). Early identification of these risk factors is crucial for timely intervention.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Virology

Background:

  • Dengue hemorrhagic fever (DHF) is a severe mosquito-borne viral illness.
  • Dengue shock syndrome (DSS) represents the most critical stage of DHF.
  • Identifying risk factors for DSS in pediatric patients is vital for improving outcomes.

Purpose of the Study:

  • To evaluate clinical and biochemical risk factors associated with the development of dengue shock syndrome (DSS) in pediatric patients diagnosed with dengue hemorrhagic fever (DHF).

Main Methods:

  • Retrospective analysis of medical records from 483 pediatric patients (≤18 years) with DHF (IgM serology positive).
  • Patients were categorized into DHF (grades I-II) and DSS (grades III-IV) groups.
  • Univariate and multivariate logistic regression analyses were employed to identify significant risk factors (p<0.05).

Main Results:

  • Significant risk factors for shock in pediatric DHF patients included spontaneous bleeding, hepatomegaly, and signs of capillary leakage (ascites, pleural effusion).
  • Leukopenia (<4000 cells/mm³) and age greater than 5 years were also identified as significant risk factors.
  • The study identified 78 children who progressed to DSS from an initial cohort of 483 DHF patients.

Conclusions:

  • Spontaneous bleeding, hepatomegaly, capillary leakage, leukopenia, and older age (>5 years) are key indicators for predicting DSS development in pediatric DHF.
  • These findings can aid clinicians in early risk stratification and management of pediatric dengue patients.
  • Further research could explore specific pathophysiological mechanisms linking these factors to shock progression.

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