Lee et al reported a decision tree for identifying the risk of Dengue Hemorrhagic Fever (DHF) in a patient with dengue fever. The authors are from Tan Tock Seng Hospital and National Healthcare Group in Singapore.
Patient selection: consistent with dengue fever in Emergency Department
Features of Dengue Hemorrhagic Fever: fever, thrombocytopenia (platelet count < 100,000 per µL), bleeding and plasma leakage
Parameters in the Emergency Department:
(1) history of bleeding (bleeding gums, nosebleed, menorrhagia, GI bleeding)
(2) serum urea in mmol/L
(3) serum total protein in g/L
Bleeding
Urea
Total Protein
Percent DHF
Yes
NA
NA
33%
No
> 4 mmol/L
NA
3%
No
<= 4 mmol/L
> 67 g/L
0%
No
<= 4 mmol/L
<= 67 g/L
2%
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