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Description

John et al reported risk factors for bleeding and for mortality in a patent with dengue fever. These can help to identify a patient who may require more aggressive management. The authors are from Christian Medical College in Vellore, India.

 


Patient selection: dengue fever

 

Dengue cases were classified by the 2009 WHO criteria:

(1) dengue without warning signs

(2) dengue with warning signs

(3) severe dengue

 

Primary dengue: IgM antibody positive OR NSI antigen positive

Secondary dengue: IgG antibody positive, with or without IgM

 

Risk factors for bleeding (from Table 3):

(1) elevated AST (> 600 IU/L) and ALT (> 400 IU/L)

(2) severe dengue

(3) secondary dengue

 

Risk factors for mortality (from Table 4):

(1) older age (> 40 years)

(2) elevated WBC count (>= 10,000 per µL)

(3) elevated serum total bilirubin (> 35 µmol/L)

(4) elevated serum creatinine (> 100 µmol/L)

(5) elevated AST (> 1,000 IU/L) and ALT (> 500 IU/L)

(6) high SOFA score (>= 5)


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