Prognostic factors associated with dengue shock syndrome in dengue hemorrhagic fever in pediatric patients, Mukdahan Hospital

Abstract

Background: Dengue hemorrhagic fever (DHF) is an important disease, including diagnosis and treatment. Knowing the prognostic factors associated with dengue shock syndrome (DSS) in dengue hemorrhagic fever in pediatric patients will help in monitoring and treatment more effectively.

Objective: To determine clinical characteristics and the prognostic factors associated with dengue shock syndrome in dengue hemorrhagic fever in pediatric patients.

Method: A retrospective observational study using a prognostic factor research approach was conducted in a pediatric ward, Mukdahan Hospital. Patients aged 1 month to 15 years with a diagnosis of dengue hemorrhagic fever were enrolled between 1 October 2016 to 31 May 2024. Chi-square test and multivariate logistic regression were used to identify prognostic factors associated with dengue shock syndrome.

Result: A total of 120 patients were enrolled in this study and 34 patients (28.3%) were diagnosed with dengue shock syndrome. The most common age group was 10-13 years old (46.7%). The three most common presenting symptoms were fever (100.0 %), nausea (35.0%) and vomiting (34.2%). On multivariate analysis, the significant factors associated with dengue shock syndrome were nutrition status (risk ratio [RR] 11.8, 95% CI 1.4-103.6, p value 0.03), bleeding per gum (RR 16.7, 95% CI 1.2-233.8, p value 0.04) and pleural effusion (RR 14.9, 95% CI 2.2 -101.1, p value 0.01).

Conclusion: Pediatric patients with dengue hemorrhagic fever should be closely monitored during treatment, especially those with abnormal nutrition status, bleeding per gum and pleural effusion.