TY - JOUR
T1 - Dengue score as a diagnostic predictor for pleural effusion and/or ascites
T2 - External validation and clinical application
AU - Suwarto, Suhendro
AU - Hidayat, Mohammad Jauharsyah
AU - Widjaya, Bing
N1 - Funding Information:
This study was supported by an internal grant from Pondok Indah Hospital in Jakarta, Indonesia.
Publisher Copyright:
© 2018 The Author(s).
PY - 2018/2/23
Y1 - 2018/2/23
N2 - Background: The Dengue Score is a model for predicting pleural effusion and/or ascites and uses the hematocrit (Hct), albumin concentration, platelet count and aspartate aminotransferase (AST) ratio as independent variables. As this metric has not been validated, we conducted a study to validate the Dengue Score and assess its clinical application. Methods: A retrospective study was performed at a private hospital in Jakarta, Indonesia. Patients with dengue infection hospitalized from January 2011 through March 2016 were included. The Dengue Score was calculated using four parameters: Hct increase≥15.1%, serum albumin≤3.49mg/dL, platelet count≤49,500/μL and AST ratio≥2.51. Each parameter was scored as 1 if present and 0 if absent. To validate the Dengue Score, goodness-of-fit was used to assess calibration, and the area under the receiver operating characteristic curve (AROC) was used to assess discrimination. Associations between clinical parameters and Dengue Score groups were determined by bivariate analysis. Results: A total of 207 patients were included in this study. The calibration of the Dengue Score was acceptable (Hosmer-Lemeshow test, p=0.11), and the score's discriminative ability was good (AROC=0.88 (95% CI: 0.83-0.92)). At a cutoff of ≥2, the Dengue Score had a positive predictive value (PPV) of 79.03% and a negative predictive value (NPV) of 90.36% for the diagnostic prediction of pleural effusion and/or ascites. Compared with the Dengue Score≤1 group, the Dengue Score=2 group was significantly associated with hemoconcentration> 20% (p=0.029), severe thrombocytopenia (p=0.029), and increased length of hospital stay (p=0.003). Compared with the Dengue Score=2 group, the Dengue Score≥3 group was significantly associated with hemoconcentration> 20% (p=0.001), severe thrombocytopenia (p=0.024), severe dengue (p=0.039), and increased length of hospital stay (p=0.011). Conclusion: The Dengue Score performed well and can be used in daily practice to help clinicians identify patients who have plasma leakage associated with severe dengue.
AB - Background: The Dengue Score is a model for predicting pleural effusion and/or ascites and uses the hematocrit (Hct), albumin concentration, platelet count and aspartate aminotransferase (AST) ratio as independent variables. As this metric has not been validated, we conducted a study to validate the Dengue Score and assess its clinical application. Methods: A retrospective study was performed at a private hospital in Jakarta, Indonesia. Patients with dengue infection hospitalized from January 2011 through March 2016 were included. The Dengue Score was calculated using four parameters: Hct increase≥15.1%, serum albumin≤3.49mg/dL, platelet count≤49,500/μL and AST ratio≥2.51. Each parameter was scored as 1 if present and 0 if absent. To validate the Dengue Score, goodness-of-fit was used to assess calibration, and the area under the receiver operating characteristic curve (AROC) was used to assess discrimination. Associations between clinical parameters and Dengue Score groups were determined by bivariate analysis. Results: A total of 207 patients were included in this study. The calibration of the Dengue Score was acceptable (Hosmer-Lemeshow test, p=0.11), and the score's discriminative ability was good (AROC=0.88 (95% CI: 0.83-0.92)). At a cutoff of ≥2, the Dengue Score had a positive predictive value (PPV) of 79.03% and a negative predictive value (NPV) of 90.36% for the diagnostic prediction of pleural effusion and/or ascites. Compared with the Dengue Score≤1 group, the Dengue Score=2 group was significantly associated with hemoconcentration> 20% (p=0.029), severe thrombocytopenia (p=0.029), and increased length of hospital stay (p=0.003). Compared with the Dengue Score=2 group, the Dengue Score≥3 group was significantly associated with hemoconcentration> 20% (p=0.001), severe thrombocytopenia (p=0.024), severe dengue (p=0.039), and increased length of hospital stay (p=0.011). Conclusion: The Dengue Score performed well and can be used in daily practice to help clinicians identify patients who have plasma leakage associated with severe dengue.
KW - Clinical application
KW - Dengue score
KW - External validation
UR - http://www.scopus.com/inward/record.url?scp=85042462567&partnerID=8YFLogxK
U2 - 10.1186/s12879-018-2996-x
DO - 10.1186/s12879-018-2996-x
M3 - Article
C2 - 29471786
AN - SCOPUS:85042462567
SN - 1471-2334
VL - 18
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
IS - 1
M1 - 90
ER -