Risk factors for dengue shock syndrome in children admitted in Federal Govt. Polyclinic Hospital.Islamabad

Abstract

Objective:  To determine the risk factors for dengue shock syndrome in children admitted in Federal Govt. Polyclinic Hospital (FGPC) Islamabad.
Methodology:  It is a descriptive cross sectional study was conducted in Pediatric ward and Intensive care unit of Pediatric department of Federal Govt. Polyclinic hospital, Islamabad from August 2019 to October 2019. Children from1month to 12 years of age with dengue fever (DF) were enrolled in the study by non-probability sampling technique. We took history, did examination and investigation in 102 children reported at Pediatric department, polyclinic hospital Islamabad between August’ 2019 to October ‘2019. Epidemiologic variables of interest included age and sex. Clinical variables of interest included fever, duration of fever, petechiae, spontaneous bleed, melena, hematuria, gum bleed, rash, pleural effusion, ascites, hepatomegaly and duration of stay. Pathological variable included complete Blood Count (CBC) and dengue NS1Antigen.

Result: A total of 102 patients were enrolled in the study, there were 63 (61.8%) males and 39 (38.2%) females with mean age of 91.55±36.7 to 96.17±35.94 months. Out of 102 patients admitted with dengue fever (DF)/dengue hemorrhagic fever (DHF), 13 (12.7%) developed ascites, pleural effusion and capillary refill time of more than 3 seconds, were labelled as experiencing dengue shock syndrome (DSS). Patients with capillary refill time of more than 3 seconds were found to be 2.44 times more likely to develop dengue shock syndrome (OR=2.44, 95% CI 1.47 – 4.03, p<0.001). Similarly, patients with thrombocytopenia (platelet count less than 150x103 cells) and leukocytopenia (TLC less than 4000x103 cells) were found to be at increased risk of developing dengue shock syndrome as compared to others (OR=1.28, 95% CI 1.12 – 1.48, p=0.001 and OR=1.6, 95% CI 1.12 – 5.21, p=0.01 respectively). Out of 13(12.7%) patients with DSS 1 patient (7.7%) died but no mortality observed in DHF.

Conclusion: The univariate analysis revealed increased capillary refill time, thrombocytopenia and leukocytopenia to be significant predictors of dengue shock syndrome (DSS).