Background The study aimed to identify predictors of severe dengue during the 2017 epidemic and to develop and validate a simple predictive score for severity. Methods A retrospective analytical study was conducted using clinical and laboratory data from adult dengue patients with a confirmed microbiological diagnosis. The study included patients who presented to a tertiary care centre in Kerala, India, during the febrile phase (≤4 d) between June 2017 and February 2019. Using appropriate statistical tests, we derived predictors of severe disease and computed a risk score model. Results Of the 153 patients (mean age 50±17 y; 64% males), 31 (20%) had severe dengue and 4 (3%) died. Petechial lesions, hypoalbuminemia (<3.5 g/dl), elevated alanine aminotransferase (>40 IU/l) and urea >40 IU/l were significant predictors. Our scoring system (cut-off: 2) showed excellent performance, with an area under the receiver operating characteristics curve of 0.9741, sensitivity of 100%, specificity of 96% and accuracy of 98%. The risk score was secondarily validated on 48 patients hospitalized from March 2019 to June 2019. Conclusion Our scoring system is easy to implement and will help primary healthcare practitioners in promptly identifying severe dengue cases upon hospital presentation.

中文翻译：

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印度喀拉拉邦一家三级医院确诊登革热患者严重程度的预测评分

背景 该研究旨在确定 2017 年流行期间严重登革热的预测因子，并开发和验证严重程度的简单预测评分。方法利用已确诊微生物学诊断的成年登革热患者的临床和实验室数据进行回顾性分析研究。该研究纳入了 2017 年 6 月至 2019 年 2 月期间在印度喀拉拉邦三级护理中心就诊的发热期（≤4 天）的患者。通过适当的统计检验，我们得出了严重疾病的预测因素并计算了风险评分模型。结果 153 名患者（平均年龄 50±17 岁；64% 为男性）中，31 名（20%）患有严重登革热，4 名（3%）死亡。瘀点病变、低白蛋白血症(＜3.5g/dl)、丙氨酸转氨酶升高(＞40IU/l)和尿素＞40IU/l是显着的预测因子。我们的评分系统（截止值：2）表现出优异的性能，受试者工作特征曲线下面积为 0.9741，灵敏度为 100%，特异性为 96%，准确度为 98%。风险评分对 2019 年 3 月至 2019 年 6 月住院的 48 名患者进行了二次验证。结论我们的评分系统易于实施，将有助于初级保健从业者在入院时及时识别重症登革热病例。