Development of a bedside score to predict dengue severity.
Arboviruses
Dengue
Hospital triage
Operational tool
Pacific
Severity score
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
24 May 2021
24 May 2021
Historique:
received:
22
11
2019
accepted:
06
05
2021
entrez:
25
5
2021
pubmed:
26
5
2021
medline:
3
6
2021
Statut:
epublish
Résumé
In 2017, New Caledonia experienced an outbreak of severe dengue causing high hospital burden (4379 cases, 416 hospital admissions, 15 deaths). We decided to build a local operational model predictive of dengue severity, which was needed to ease the healthcare circuit. We retrospectively analyzed clinical and biological parameters associated with severe dengue in the cohort of patients hospitalized at the Territorial Hospital between January and July 2017 with confirmed dengue, in order to elaborate a comprehensive patient's score. Patients were compared in univariate and multivariate analyses. Predictive models for severity were built using a descending step-wise method. Out of 383 included patients, 130 (34%) developed severe dengue and 13 (3.4%) died. Major risk factors identified in univariate analysis were: age, comorbidities, presence of at least one alert sign, platelets count < 30 × 10 We built robust and efficient models to calculate a bedside score able to predict dengue severity in our setting. We propose the spreadsheet for dengue severity score calculations to health practitioners facing dengue outbreaks of enhanced severity in order to improve patients' medical management and hospitalization flow.
Sections du résumé
BACKGROUND
BACKGROUND
In 2017, New Caledonia experienced an outbreak of severe dengue causing high hospital burden (4379 cases, 416 hospital admissions, 15 deaths). We decided to build a local operational model predictive of dengue severity, which was needed to ease the healthcare circuit.
METHODS
METHODS
We retrospectively analyzed clinical and biological parameters associated with severe dengue in the cohort of patients hospitalized at the Territorial Hospital between January and July 2017 with confirmed dengue, in order to elaborate a comprehensive patient's score. Patients were compared in univariate and multivariate analyses. Predictive models for severity were built using a descending step-wise method.
RESULTS
RESULTS
Out of 383 included patients, 130 (34%) developed severe dengue and 13 (3.4%) died. Major risk factors identified in univariate analysis were: age, comorbidities, presence of at least one alert sign, platelets count < 30 × 10
CONCLUSION
CONCLUSIONS
We built robust and efficient models to calculate a bedside score able to predict dengue severity in our setting. We propose the spreadsheet for dengue severity score calculations to health practitioners facing dengue outbreaks of enhanced severity in order to improve patients' medical management and hospitalization flow.
Identifiants
pubmed: 34030658
doi: 10.1186/s12879-021-06146-z
pii: 10.1186/s12879-021-06146-z
pmc: PMC8142072
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
470Références
Arch Virol. 2013 Jul;158(7):1445-59
pubmed: 23471635
Cancer. 1950 Jan;3(1):32-5
pubmed: 15405679
BMC Pediatr. 2018 Mar 13;18(1):109
pubmed: 29534694
PLoS Negl Trop Dis. 2014 Jul 10;8(7):e2972
pubmed: 25010515
PLoS Negl Trop Dis. 2010 Aug 03;4(8):e769
pubmed: 20689812
N Engl J Med. 2018 Jul 26;379(4):327-340
pubmed: 29897841
BMC Infect Dis. 2011 May 12;11:123
pubmed: 21569427
BMC Infect Dis. 2016 Jul 08;16:320
pubmed: 27393011
PLoS One. 2015 Jun 19;10(6):e0129046
pubmed: 26090676
PLoS Negl Trop Dis. 2012;6(5):e1641
pubmed: 22563519
Virol J. 2014 Mar 31;11:61
pubmed: 24684835
PLoS One. 2016 May 03;11(5):e0154772
pubmed: 27138448
PLoS One. 2018 Jul 10;13(7):e0200200
pubmed: 29990356
PLoS Negl Trop Dis. 2010 Jun 01;4(6):e699
pubmed: 20532230
Nature. 2013 Apr 25;496(7446):504-7
pubmed: 23563266
Acta Trop. 2020 Jan;201:105201
pubmed: 31562846
Clin Infect Dis. 2017 Mar 1;64(5):656-663
pubmed: 28034883
PLoS One. 2014 Nov 21;9(11):e113677
pubmed: 25415265
Trop Med Infect Dis. 2019 Jun 20;4(2):
pubmed: 31226729
Nat Rev Dis Primers. 2016 Aug 18;2:16055
pubmed: 27534439
PLoS Negl Trop Dis. 2018 Oct 4;12(10):e0006497
pubmed: 30286085
Sci Rep. 2017 Jan 03;7:39872
pubmed: 28045096
Scand J Infect Dis. 2006;38(8):675-81
pubmed: 16857614