Prediction of plasma leakage phase of dengue in resource limited settings
Autor: | H. M. M. T. B. Herath, Nilukshana Yogendranathan, Aruna Kulatunga, W. D. Jayamali, S. S. M. Samarawickrama, W. A. E. Udeshika, Chaturaka Rodrigo |
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Rok vydání: | 2019 |
Předmět: |
Microbiology (medical)
medicine.medical_specialty Abdominal pain 030219 obstetrics & reproductive medicine Epidemiology Liver tenderness business.industry Public Health Environmental and Occupational Health Plasma leakage medicine.disease Increased capillary permeability Dengue fever 03 medical and health sciences 0302 clinical medicine Infectious Diseases Internal medicine medicine Vomiting Observational study 030212 general & internal medicine medicine.symptom business Limited resources |
Zdroj: | Clinical Epidemiology and Global Health. 7:279-282 |
ISSN: | 2213-3984 |
DOI: | 10.1016/j.cegh.2018.10.006 |
Popis: | Introduction The pathophysiology of severe dengue is related to increased capillary permeability and plasma leakage into extracellular space. A simple, low cost risk prediction tool for plasma leakage will be useful for clinicians practicing in rural areas without imaging facilities. Study design A prospective observational study was carried out over 12 months at the National Hospital, Sri Lanka enrolling patients with confirmed diagnosis (via NS1 antigen testing) of early dengue infection. Clinical features on admission and investigation results on D3, D5 and D7 of the illness were recorded. Evidence of plasma leakage was confirmed by ultrasonography. Results A total of 179 patients met the inclusion criteria (males; 91, 50.8%, mean age: 31.6 years, SD ± 14.7). Sixty seven patients (67/173, 38.7%) had ultrasonographic evidence of plasma leakage. Several clinical features (severe vomiting, severe diarrhoea, abdominal pain and liver tenderness) as well as mean differences of some investigations were significantly associated with progression to plasma leakage. However, only liver tenderness on day 3 emerged as independent significant predictors of critical phase in the adjusted analysis (specificity: 93%, sensitivity: 44%). Conclusions Having liver tenderness by day 3 of the illness is helpful to identify a subgroup of patients at risk of plasma leakage. |
Databáze: | OpenAIRE |
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