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Nomogram of Tuan et al for Predicting Severe Dengue Fever in a Child (Early Severe Dengue Identifier, ESDI)

Description

Tuan et al reported a nomogram for predicting severe disease in a patient with dengue fever. This can help to identify a patient who may require more aggressive management. The authors are from Oxford University, Children's Hospital No. 2 Ho Chi Minh City, University of Melbourne and other hospitals in Vietnam.


Patient selection: child with dengue fever

 

Parameters:

(1) vomiting

(2) platelet count per microliter, from 0 to 900,000

(3) serum AST as multiple of upper limit of normal, from 3 to 12

(4) nonstructural protein 1 (NS1) using a rapid test

 

points for platelet count =

= 100 - (0.1111 * (platelet count) / 1000)

 

Parameter

Finding

Points

vomiting

no

0

 

yes

5

NS1

negative

0

 

positive

14

AST as multiple ULN

< 3

0

 

3 to 12

(6.5833 * (multiple)) - 19.75

 

total score =

= SUM(points for all of the parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 178.25

 

Score

Percent with Severe Dengue

< 120

< 6%

120 to 140

(0.078083 * ((score)^2)) - (17.748 * (score)) + 1011.5

140 to 155

(-0.097419 * ((score)^2)) + (31.112 * (score)) - 2389.5

> 155

> 92%

 

Performance:

• The area under the ROC curve is reported as 0.95.


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