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Indian Journal of Trauma and Emergency Pediatrics

Volume  13, Issue 1, JAN-MARCH 2021, Pages 15-19
 

Original Article

Blood Investigations as Predictive Tool for Predicting Bleeding Manifestations and Death with Dengue like Illnesses

Punam Uke1, Akash Bang2, Bhavana Lakhkar3

1Assistant Professor, Department of Paediatric, 3Professor and Head, Department of Neonatology, Jawaharlal Nehru Medical College, Sawangi, Wardha, Maharashtra 442001, India. 2Additional Professor, Department of Paediatric, AIIMS Nagpur, Maharashtra 440003, India.

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DOI: http://dx.doi.org/10.21088/ijtep.2348.9987.13121.2

Abstract

Background: Dengue has a broad range spectrum of clinical presentations and many times unpredictable clinical evolution and outcome. Though the disease is complex in its manifestations, management is relatively simple hence it is very important to be able to predict which patients are more likely to land up in complications like bleeding manifestation and death. There is a paucity of literature on this. Objective: To study blood investigation parameters as predictive tool for predicting bleeding manifestations and death in children with dengue like illnesses. Methods: We enrolled all the consecutive admissions to pediatric ward of a tertiary care teaching hospital satisfying the inclusion criteria from February 2014 to May 2015. Blood investigations were sent and patients were assessed for appearance of bleeding manifestations and death. Results: 200 children were enrolled of age group 3 month to 12 years. Investigation parameters are predictors of outcome of bleeding in mortality group Vs survivals (TLC - 4.81±2.69 Vs 5.97±4.84; p=0.031, Platelet-65.50±32.89 Vs 79.66±39.46; p=0.010, Highest haematocrit-40.67±3.89 Vs 38.77±4.45; p=0.003). Patients having bleeding have more dengue positivity (p=0.0001) with maximum positivity for NS1 69%. Hb% on admission and lowest Hb% were significantly lower in mortality group than in survival group. Conclusion: 3 patients died and bleeding manifestations were present in 74 patients out of 200 patients. Investigation parameters are predictors of outcome of bleeding in mortality group Vs survivals. Dengue positivity was not a significant factor for prediction of death.

 


Keywords : Clinical Presentations; Dengue; Investigations; Predictors.
Corresponding Author : Punam Uke