Predictors of plasma leakage among dengue patients in Thailand: A plasma-leak score analysis.

Predictors of plasma leakage among dengue patients in Thailand: A plasma-leak score analysis.

Delayed plasma leakage recognition could lead to improper fluid administration resulting in dengue shock syndrome, subsequently, multi-organ failure, and death. This prospective observational study was conducted in Bangkok, Thailand, between March 2018 and February 2020 to determine predictors of pl...

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Autores principales: Sutopa Talukdar, Vipa Thanachartwet, Varunee Desakorn, Supat Chamnanchanunt, Duangjai Sahassananda, Mukda Vangveeravong, Siripen Kalayanarooj, Anan Wattanathum
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Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2021
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Science
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Acceso en línea:https://doaj.org/article/83d219c9bd9943c88e72dcc869763053
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spelling oai:doaj.org-article:83d219c9bd9943c88e72dcc8697630532021-12-02T20:08:56ZPredictors of plasma leakage among dengue patients in Thailand: A plasma-leak score analysis.1932-620310.1371/journal.pone.0255358https://doaj.org/article/83d219c9bd9943c88e72dcc8697630532021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255358https://doaj.org/toc/1932-6203Delayed plasma leakage recognition could lead to improper fluid administration resulting in dengue shock syndrome, subsequently, multi-organ failure, and death. This prospective observational study was conducted in Bangkok, Thailand, between March 2018 and February 2020 to determine predictors of plasma leakage and develop a plasma leakage predictive score among dengue patients aged ≥15 years. Of 667 confirmed dengue patients, 318 (47.7%) developed plasma leakage, and 349 (52.3%) had no plasma leakage. Multivariate analysis showed three independent factors associated with plasma leakage, including body mass index ≥25.0 kg/m2 (odds ratio [OR] = 1.784; 95% confidence interval [CI] = 1.040-3.057; P = 0.035), platelet count <100,000/mm3 on fever days 3 to 4 (OR = 2.151; 95% CI = 1.269-3.647; P = 0.004), and aspartate aminotransferase or alanine aminotransferase ≥100 U/l on fever days 3 to 4 (OR = 2.189; 95% CI = 1.231-3.891; P = 0.008). Because these three parameters had evidence of equality, each independent factor was weighted to give a score of 1 with a total plasma-leak score of 3. Higher scores were associated with increased plasma leakage occurrence, with ORs of 2.017 (95% CI = 1.052-3.869; P = 0.035) for score 1, 6.158 (95% CI = 2.914-13.015; P <0.001) for score 2, and 6.300 (95% CI = 2.419-16.407; P <0.001) for score 3. The area under the receiver operating characteristics curves for predicting plasma leakage was good (0.677 [95% CI = 0.616-0.739]). Patients with a plasma-leak score ≥1 had high sensitivity (88.8%), and those with a plasma-leak score of 3 had high specificity (93.4%) for plasma leakage occurrence. This simple and easily accessible clinical score might help physicians provide early and timely appropriate clinical dengue management in endemic areas.Sutopa TalukdarVipa ThanachartwetVarunee DesakornSupat ChamnanchanuntDuangjai SahassanandaMukda VangveeravongSiripen KalayanaroojAnan WattanathumPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0255358 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Sutopa Talukdar
Vipa Thanachartwet
Varunee Desakorn
Supat Chamnanchanunt
Duangjai Sahassananda
Mukda Vangveeravong
Siripen Kalayanarooj
Anan Wattanathum
Predictors of plasma leakage among dengue patients in Thailand: A plasma-leak score analysis.
description Delayed plasma leakage recognition could lead to improper fluid administration resulting in dengue shock syndrome, subsequently, multi-organ failure, and death. This prospective observational study was conducted in Bangkok, Thailand, between March 2018 and February 2020 to determine predictors of plasma leakage and develop a plasma leakage predictive score among dengue patients aged ≥15 years. Of 667 confirmed dengue patients, 318 (47.7%) developed plasma leakage, and 349 (52.3%) had no plasma leakage. Multivariate analysis showed three independent factors associated with plasma leakage, including body mass index ≥25.0 kg/m2 (odds ratio [OR] = 1.784; 95% confidence interval [CI] = 1.040-3.057; P = 0.035), platelet count <100,000/mm3 on fever days 3 to 4 (OR = 2.151; 95% CI = 1.269-3.647; P = 0.004), and aspartate aminotransferase or alanine aminotransferase ≥100 U/l on fever days 3 to 4 (OR = 2.189; 95% CI = 1.231-3.891; P = 0.008). Because these three parameters had evidence of equality, each independent factor was weighted to give a score of 1 with a total plasma-leak score of 3. Higher scores were associated with increased plasma leakage occurrence, with ORs of 2.017 (95% CI = 1.052-3.869; P = 0.035) for score 1, 6.158 (95% CI = 2.914-13.015; P <0.001) for score 2, and 6.300 (95% CI = 2.419-16.407; P <0.001) for score 3. The area under the receiver operating characteristics curves for predicting plasma leakage was good (0.677 [95% CI = 0.616-0.739]). Patients with a plasma-leak score ≥1 had high sensitivity (88.8%), and those with a plasma-leak score of 3 had high specificity (93.4%) for plasma leakage occurrence. This simple and easily accessible clinical score might help physicians provide early and timely appropriate clinical dengue management in endemic areas.
format article
author Sutopa Talukdar
Vipa Thanachartwet
Varunee Desakorn
Supat Chamnanchanunt
Duangjai Sahassananda
Mukda Vangveeravong
Siripen Kalayanarooj
Anan Wattanathum
author_facet Sutopa Talukdar
Vipa Thanachartwet
Varunee Desakorn
Supat Chamnanchanunt
Duangjai Sahassananda
Mukda Vangveeravong
Siripen Kalayanarooj
Anan Wattanathum
author_sort Sutopa Talukdar
title Predictors of plasma leakage among dengue patients in Thailand: A plasma-leak score analysis.
title_short Predictors of plasma leakage among dengue patients in Thailand: A plasma-leak score analysis.
title_full Predictors of plasma leakage among dengue patients in Thailand: A plasma-leak score analysis.
title_fullStr Predictors of plasma leakage among dengue patients in Thailand: A plasma-leak score analysis.
title_full_unstemmed Predictors of plasma leakage among dengue patients in Thailand: A plasma-leak score analysis.
title_sort predictors of plasma leakage among dengue patients in thailand: a plasma-leak score analysis.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/83d219c9bd9943c88e72dcc869763053
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