Early predictors of haemorrhage in acute febrile syndrome patients from Bucaramanga, Colombia: a dengue endemic area

Díaz-Quijano FA, Martínez-Vega RA, Villar-Centeno LA
Correspondence: Dr Fredi Alexander Díaz Quijano, fre_diazq@yahoo.com

ABSTRACT
Introduction Spontaneous haemorrhage is an important cause of hospitalisation in dengue patients. Early predictors of these complications could help to make opportune decisions.
Methods We prospectively evaluated 51 febrile patients (without previous spontaneous haemorrhage), including 32 cases of dengue fever. Initial evaluation was performed during the first 96 hours after the onset of fever and included complete blood cell count and coagulation tests. Participants were followed-up daily until the seventh day of the disease.
Results Overall, 15 patients developed spontaneous haemorrhage during the follow-up. Tourniquet test and dengue infection were not associated with haemorrhage (p-value is greater than 0.2). In a logistic regression analysis, platelet count (odds-ratio [OR] 0.78; 95 percent confidence interval [CI] 0.65-0.94) and partial thromboplastin time (OR 1.78; 95 percent CI 1.06-2.99) were independently associated with spontaneous haemorrhage.
Conclusion Early alterations in platelet count and coagulation test could predict spontaneous bleeding in the acute febrile syndrome.

Keywords: acute febrile syndrome, dengue fever, dengue haemorrhagic fever, platelet count alteration, spontaneous haemorrhage
Singapore Med J 2008; 49(6): 480-482