Development of clinical decision rules to predict recurrent shock in dengue.
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ABSTRACT: Introduction
Mortality from dengue infection is mostly due to shock. Among dengue patients with shock, approximately 30% have recurrent shock that requires a treatment change. Here, we report development of a clinical rule for use during a patient's first shock episode to predict a recurrent shock episode.Methods
The study was conducted in Center for Preventive Medicine in Vinh Long province and the Children's Hospital No. 2 in Ho Chi Minh City, Vietnam. We included 444 dengue patients with shock, 126 of whom had recurrent shock (28%). Univariate and multivariate analyses and a preprocessing method were used to evaluate and select 14 clinical and laboratory signs recorded at shock onset. Five variables (admission day, purpura/ecchymosis, ascites/pleural effusion, blood platelet count and pulse pressure) were finally trained and validated by a 10-fold validation strategy with 10 times of repetition, using a logistic regression model.Results
The results showed that shorter admission day (fewer days prior to admission), purpura/ecchymosis, ascites/pleural effusion, low platelet count and narrow pulse pressure were independently associated with recurrent shock. Our logistic prediction model was capable of predicting recurrent shock when compared to the null method (P?ConclusionsOur simple clinical rule is not to replace clinical judgment, but to help clinicians predict recurrent shock during a patient's first dengue shock episode.
SUBMITTER: Huy NT
PROVIDER: S-EPMC4057383 | biostudies-literature | 2013 Dec
REPOSITORIES: biostudies-literature
Publications
Development of clinical decision rules to predict recurrent shock in dengue.
Huy Nguyen Tien NT Thao Nguyen Thanh Hong NT Ha Tran Thi Ngoc TT Lan Nguyen Thi Phuong NT Nga Phan Thi Thanh PT Thuy Tran Thi TT Tuan Ha Manh HM Nga Cao Thi Phi CT Tuong Vo Van VV Dat Tran Van TV Huong Vu Thi Que VT Karbwang Juntra J Hirayama Kenji K
Critical care (London, England) 20131202 6
<h4>Introduction</h4>Mortality from dengue infection is mostly due to shock. Among dengue patients with shock, approximately 30% have recurrent shock that requires a treatment change. Here, we report development of a clinical rule for use during a patient's first shock episode to predict a recurrent shock episode.<h4>Methods</h4>The study was conducted in Center for Preventive Medicine in Vinh Long province and the Children's Hospital No. 2 in Ho Chi Minh City, Vietnam. We included 444 dengue pa ...[more]
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