Early predictors of clinically significant bleeding in adults with dengue infection

Southeast Asian J Trop Med Public Health. 2012 Jul;43(4):890-9.

Abstract

Hemorrhage is an important complication in dengue infection, but early predictors of clinically significant bleeding are undefined. This study aimed to determine clinical factors on admission associated with Type I bleeding, defined as gastrointestinal bleed, hematuria and menorrhagia, among adult patients with dengue infection. We carried out a retrospective study among 277 patients aged >15 years with serologically-confirmed dengue infection admitted to the Hospital for Tropical Diseases, Bangkok, Thailand during 2006-2009. Female gender (p<0.001), vomiting (p=0.05), severe thrombocytopenia (platelet count < 25 x 10(9)/l; p=0.007), high absolute lymphocyte count (ALC >500; p=0.05) and high aspartate aminotransferase level (AST >200; p=0.02) were significantly associated with hemorrhage on univariate analysis. Multivariate analysis revealed variables associated with bleeding were female gender [odds ratio (OR) 14.5; 95% confidence interval (CI) 0.16-0.56, p<0.001], thrombocytopenia (OR 4.7; 95%CI 0.13-0.9, p=0.03) and ALC >500 (OR 5.7; 95%CI 1.17-4.99, p=0.02). These data identify patients at high risk for developing clinically significant bleeding with dengue infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Comorbidity
  • Dengue / blood
  • Dengue / complications*
  • Dengue / epidemiology
  • Dengue / physiopathology*
  • Female
  • Hemorrhage / epidemiology
  • Hemorrhage / etiology*
  • Humans
  • Male
  • Retrospective Studies
  • Socioeconomic Factors
  • Young Adult