Table of Contents
ISRN Pediatrics
Volume 2013, Article ID 845876, 6 pages
Clinical Study

Development of Dengue Infection Severity Score

1Program in Clinical Epidemiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
2Department of Occupational Medicine, Phrae Hospital, Phrae 54000, Thailand
3Department of Social Medicine, Sawanpracharak Hospital, Nakorn Sawan 60000, Thailand
4Clinical Epidemiology Society at Chiang Mai, Chiang Mai 50200, Thailand
5Clinical Epidemiology Unit, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
6Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand

Received 13 July 2013; Accepted 12 September 2013

Academic Editors: G. J. Casimir, K. Tokiwa, and B. Vasarhelyi

Copyright © 2013 Surangrat Pongpan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. To develop a simple scoring system to predict dengue infection severity based on patient characteristics and routine clinical profiles. Methods. Retrospective data of children with dengue infection from 3 general hospitals in Thailand were reviewed. Dengue infection was categorized into 3 severity levels: dengue infection (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). Coefficients of significant predictors of disease severity under ordinal regression analysis were transformed into item scores. Total scores were used to classify patients into 3 severity levels. Results. Significant clinical predictors of dengue infection severity were age >6 years, hepatomegaly, hematocrit 40%, systolic pressure <90 mmHg, white cell count >5000 /μL, and platelet ≤50000 /μL. The derived total scores, which ranged from 0 to 18, classified patients into 3 severity levels: DF (scores <2.5, , 58.1%), DHF (scores 2.5–11.5, , 35.5%), and DSS (scores >11.5, , 6.4%). The derived score correctly classified patients into their original severity levels in 60.7%. An under-estimation of 25.7% and an over-estimation of 13.5% were clinically acceptable. Conclusions. The derived dengue infection severity score classified patients into DF, DHF, or DSS, correctly into their original severity levels. Validation of the score should be reconfirmed before application of routine practice.