Which factors can help predict plasma leakage in dengue patients?

Body mass index (BMI), platelet count, and aspartate (AST) or alanine (ALT) aminotransferase levels are all important predictors of plasma leakage among dengue patients, a recent Thailand study has found.

A plasma-leak score consisting of these three variables can help clinicians easily assess the risk of their patients and provide timely intervention.

Researchers conducted a prospective observational analysis of 667 confirmed dengue patients (median age 26 years, 52.2 percent men), of whom 318 developed plasma leakage while 349 did not. The latter group had a significantly lower proportion of men (p=0.01) and BMI (p=0.009).

Multivariate logistic regression analysis revealed that BMI ≥25.0 kg/m² was a significant and independent predictor of plasma leakage (odds ratio [OR], 1.795, 95 percent confidence interval [CI], 1.040–3.057; p=0.035).

Similarly, platelet count <100,000/mm³ (OR, 2.151, 95 percent CI, 1.269–3.647; p=0.004) and AST or ALT ≥100 U/L (OR, 2.189, 95 percent CI, 1.231–3.891; p=0.008) on days 3–4 of fever onset also emerged as significant correlates of plasma leakage.

Since the above three parameters showed evidence of equality, they were each assigned a weighted score of 1 point, yielding a plasma-leak score of 3 points.

Logistic regression showed that earning a score of 1, 2, or 3 points corresponded to plasma leakage ORs of 2.017 (95 percent CI, 1.052–3.869; p=0.035), 6.158 (95 percent CI, 2.914–13.015; p<0.001), and 6.300 (95 percent CI, 2.419–16.407; p<0.001), respectively. The plasma-leak score had an area under the receiver operating characteristic curve of 0.677.