Prognostic Model of Lam et al for Profound Shock in a Child with Dengue Shock Syndrome (DSS)

Description

Lam et al reported a model for predicting profound shock in a child with Dengue Shock Syndrome (DSS). The authors are from Hospital for Tropical Diseases (Ho Chi Minh City), University of Medicine and Pharmacy of Ho Chi Minh City and the University of Oxford.

Patient selection: child with Dengue Shock Syndrome, from 7 to 12

Profound shock - any of the following:

(1) >= 2 recurrent shock episodes AND compensated shock

(2) >= 1 recurrent shock episodes AND decompensated shock

(3) need for vasopressor support

Parameters:

(1) age in years

(2) day of illness

(3) pulse in beats per minute

(4) temperature in °C

(5) hematocrit in percent

(6) hemodynamic "index" and sex

Age	Systolic BP	Pulse Pressure	Hemodynamic Index
< 5 years	>= 80 mm Hg	>= 10	1
>= 5 years	>= 90 mm Hg	>= 10	1
NA	NA	< 10	2
< 5 years	< 80 mm Hg	NA	2
>= 5 years	< 90 mm Hg	NA	2
NA	unmeasurable	NA	3

Parameters	Findings	Points
age in years		15 - (years)
day of illness	0 to 3	7
	4	5
	5	4
	6	2
	>= 7	0
pulse	< 90	0
	90 to 109	1
	110 to 129	2
	130 to 149	3
	150 to 169	4
	170 to 189	5
	rapid, thready	6
temperature	< 37.5°C	0
	37.5 to 37.9	2
	38.0 to 38.4	3
	38.5 to 38.9	5
	>= 39°C	6
hematocrit	< 40 percent	0
	40 to 44	1
	45 to 49	4
	50 to 54	7
	55 to 59	9
	>= 60 percent	10
hemodynamic index and sex	HI 1 and female	0
	HI 2 and female	7
	HI 3 and female	8
	HI 1 and male	1
	HI 2 and male	1
	HI 3 and male	4

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 3

• maximum score: 45

Score	Percent Risk for Profound Shock
<= 30	(0.068582 * ((score)^2)) - (0.68246 * (score)) + 4.8366
> 30	(-0.074216 * ((score)^2)) + (8.2735 * (score)) - 135.18

Performance:

• The area under the ROC curve is 0.69 for internal validation.

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Prognostic Model of Lam et al for Profound Shock in a Child with Dengue Shock Syndrome (DSS)

Description

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