BACKGROUND: Singapore experienced its worst dengue outbreak in 30 years in 2004, with 9459 notified cases, of which 83% were hospitalized. OBJECTIVES: To determine predictors of dengue hemorrhagic fever (DHF) upon first presentation to hospital to aid clinicians in determining need for admission. STUDY DESIGN: We conducted a retrospective cohort study on dengue patients in Tan Tock Seng Hospital, Singapore in 2004, with patients categorized into dengue fever (DF) and DHF. Demographic, clinical, and laboratory variables upon first presentation were compared to determine the likelihood of developing DHF. RESULTS: There were 1973 dengue patients-118 (6.0%) were DHF, of which 82 (4.2%) developed DHF during hospitalization. From the multivariate analysis, patients with bleeding had an odds of developing DHF 237.6 times that of DF, a unit decrease in total protein (g/L) had an odds of 1.28 times, a unit increase in blood urea (mmol/L) had an odds of 1.31 times, and a unit decrease in lymphocyte proportion had an odds of 1.08 times. The model had a sensitivity of 97.6%, specificity of 60.2%, and may reduce 1118 (56.7%) dengue admissions. CONCLUSIONS: A few easily available clinical and laboratory results may assist clinicians in determining dengue admissions.
BACKGROUND: Singapore experienced its worst dengue outbreak in 30 years in 2004, with 9459 notified cases, of which 83% were hospitalized. OBJECTIVES: To determine predictors of dengue hemorrhagic fever (DHF) upon first presentation to hospital to aid clinicians in determining need for admission. STUDY DESIGN: We conducted a retrospective cohort study on dengue patients in Tan Tock Seng Hospital, Singapore in 2004, with patients categorized into dengue fever (DF) and DHF. Demographic, clinical, and laboratory variables upon first presentation were compared to determine the likelihood of developing DHF. RESULTS: There were 1973 dengue patients-118 (6.0%) were DHF, of which 82 (4.2%) developed DHF during hospitalization. From the multivariate analysis, patients with bleeding had an odds of developing DHF 237.6 times that of DF, a unit decrease in total protein (g/L) had an odds of 1.28 times, a unit increase in blood urea (mmol/L) had an odds of 1.31 times, and a unit decrease in lymphocyte proportion had an odds of 1.08 times. The model had a sensitivity of 97.6%, specificity of 60.2%, and may reduce 1118 (56.7%) dengue admissions. CONCLUSIONS: A few easily available clinical and laboratory results may assist clinicians in determining dengue admissions.
Authors: Gabriela M Marón; A Wilfrido Clará; John Wesley Diddle; Ernesto B Pleités; Laura Miller; Gene Macdonald; Elisabeth E Adderson Journal: Am J Trop Med Hyg Date: 2010-02 Impact factor: 2.345
Authors: Vernon J Lee; Angela Chow; Xiaohui Zheng; Luis R Carrasco; Alex R Cook; David C Lye; Lee-Ching Ng; Yee-Sin Leo Journal: PLoS Negl Trop Dis Date: 2012-09-27
Authors: Junxiong Pang; Agus Salim; Vernon J Lee; Martin L Hibberd; Kee Seng Chia; Yee Sin Leo; David C Lye Journal: PLoS Negl Trop Dis Date: 2012-05-01
Authors: Francisca Raimunda F Guerreiro Azin; Romelia Pinheiro Gonçalves; Maria Helena da Silva Pitombeira; Danielle Malta Lima; Ivo Castelo Branco Journal: Rev Bras Hematol Hemoter Date: 2012
Authors: Victor C Gan; David C Lye; Tun L Thein; Frederico Dimatatac; Adriana S Tan; Yee-Sin Leo Journal: PLoS One Date: 2013-04-01 Impact factor: 3.240