Accuracy of selected indicators in leaking for the management of dengue haemorrhagic fever

Aims: Conventional clinical and laboratory parameters for the management of dengue haemorrhagic fever (DHF) were validated using ultrasound scan (USS) as the gold standard.

Methods: Clinically suspected 184 patients with platelet count <100,000 were enrolled in the study.

Results: USS evidence of leaking was observed in 48% of the sample. When Hct rises >10% and >20% were used as a predictor of leaking, sensitivity and specificity of 30%, 82% (PPV 60%, NPV 56%) and 11%, 94% (PPV 63% and NPV 54%) were observed. Liver tenderness and gall bladder wall oedema (wall thickness>6mm) had sensitivity of 28%, 91% and specificity of 83% and 94% as predictors of leaking. Haematocrit rise > 10% during any stage of critical phase associated with 94% sensitivity and 37% specificity (PPV 46%, NPV 92%) in prediction of complications.

Conclusions: Rising HCT, liver tenderness and clinical detection were found to be weak predictors of onset of leaking. HCT rise was a strong predictor of complications during the leaking phase.