Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
Department of Internal Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
F1000Res. 2022 Apr 21;11:446. doi: 10.12688/f1000research.111214.1. eCollection 2022.
Dengue infection has been a worrisome cause of mortality and morbidity in children. Though numerous scoring systems have been developed, they are in the adult population or are too complicated for use in children. Pediatric dengue infection has a wide spectrum from a mild illness to severe complications and an unpredictable course. Hence the need for a predictive scoring system where the possibility of complications can be identified which can contribute to reduction in mortality and morbidity of dengue by prompt referrals and anticipatory management. Prospective case cohort study of children with confirmed dengue fever. : 303 children were included and divided into two groups - the dengue fever group and the complicated dengue group based on the WHO clinical classification. The clinical and laboratory parameters were analysed individually, cut offs identified by ROC curves and compared for significance between the two groups. The parameters that emerged were hypotension, PCV ≥ 42%, platelet count ≤ 75000 cells/cumm, WBC ≥ 7000 cells/cumm, and ALT ≥ 70U/L. Using the adjusted odd's Ratio, and coefficient, individual predictive scores were tabulated ranging from 0 to 3, with a total score of 0 to 7. A cut-off score of 2 was then identified based upon the sensitivity (84.13%) and specificity (72.50%) as the ideal score to predict complicated dengue. Internal validation of the score was done where the area under the curve for predicting complicated dengue was 0.86 (95% CI 0.8-0.92) with a P value of <0.001. : Our dengue predictive scoring system has been developed using five indicators, with a score of two and above, out of seven, suggesting increased risk of developing complications. This has been validated internally and can be used to predict complicated dengue among children.
登革热感染已成为儿童死亡率和发病率的一个令人担忧的原因。虽然已经开发了许多评分系统，但它们是针对成年人的，或者对儿童来说过于复杂。儿科登革热感染的范围很广，从轻度疾病到严重并发症和不可预测的病程。因此，需要一种预测评分系统，可以识别并发症的可能性，通过及时转诊和预期管理，有助于降低登革热的死亡率和发病率。
共纳入 303 例患儿，根据世界卫生组织临床分类将其分为登革热组和复杂登革热组。分析了两组患儿的临床和实验室参数，通过 ROC 曲线确定截断值，并比较两组间的差异。出现的参数包括低血压、PCV≥42%、血小板计数≤75000 细胞/立方毫米、白细胞计数≥7000 细胞/立方毫米和 ALT≥70U/L。
使用调整后的优势比和系数，列出了从 0 到 3 的个体预测评分，总分为 0 到 7。然后根据敏感性（84.13%）和特异性（72.50%）确定 2 分作为预测复杂登革热的最佳截断值。该评分的内部验证显示，预测复杂登革热的曲线下面积为 0.86（95%CI 0.8-0.92），P 值<0.001。
我们的登革热预测评分系统使用五个指标，总分 7 分中有 2 分或以上提示发生并发症的风险增加。该评分已在内部得到验证，可用于预测儿童中复杂登革热的发生。
