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4.Validation of the simple clinical risk score for the early detection of severe dengue in adult patients

Kathleen M. Panabang ; Leah T. Verdillo ; Gamaliel N. Garcia

Philippine Journal of Internal Medicine 2023;61(3):122-127

Background: In 2009, the World Health Organization revised the Dengue Fever guidelines to more accurately identify patients at risk of developing severe dengue. Despite these guidelines, early diagnosis of severe dengue remains challenging for clinicians. Several scoring systems have been developed to identify patients at highest risk for severe dengue however; these studies have a study population limited to children and did not include adult patients. Objective: The purpose of this study is to validate the Simple Clinical Risk Score in predicting who will develop severe Dengue among adult patients with Dengue fever. Methods: This is a prospective cohort, single-center, observational study conducted at Silliman University Medical Center from August 2019 to August 2020. A total of 481 laboratory confirmed dengue patients were included and categorized into two models based on the day of illness. Each model used a clinical risk score of 1 point as a cut-off for predicting severe Dengue. Validation was done using the risk-odds ratio and substantiated by the odds ratio, signifying that there is more likely greater association between dengue patients to develop severe dengue. Results: In model 1, a total of 339 patients were analyzed with 6 patients who achieved a score of 1 developed severe Dengue. In model 2, a total of 142 patients were analyzed and 3 patients who achieved a score of 1 developed severe dengue. Conclusion The simple clinical risk score can assist clinicians in deciding and stratifying dengue patients who need hospitalization not only in resource-limited areas but also during this height of the pandemic. While the findings had a lesser number of participants, it still remained context-specific and is able to demonstrate a predictive ability for severe disease, thereby optimizing informed decisions for hospital admissions in settings with limited laboratory resources.
Validation Study