Marois et al reported a bedside score for predicting severe dengue fever in a female. This can help to identify a patient who may require more aggressive management. The authors are from France and New Caledonia.
Patient selection: female with dengue fever
Parameters:
(1) age class
(2) hypertension
(3) mucosal bleeding
(4) fluid accumulation (clinical)
(5) non-purpuric skin rash
(6) platelet countper µL
(7) serum ALT as a multiple of the upper limit of normal
Parameter
Finding
Points
age
<= 10 years of age
0.92
11 to 20 years
1.17
21 to 30 years
2.05
31 to 40 years
0
41 to 60 years
1.75
> 60 years
1.26
hypertension
no
0
yes
1.54
mucosal bleeding
no
0
yes
1.54
fluid accumulation
no
0
yes
1.36
non-purpuric skin rash
no
0
yes
-0.89
platelet count
>= 30,000 per µL
0
< 30,000 per µL
1.04
serum ALT/ULN ratio
<= 10
0
> 10
2.66
value of X =
= SUM(points for all of the parameters) - 4.03
probability of severe dengue =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.95.
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