Clinical prognostic scores for dengue fever: A systematic review

Table 4 Results of prognostic score performance

Ref.	Model	Score components	Predicted outcomes	Threshold	Sensitivity (%)	Specificity (%)
Leo et al[20], 2013	Number of warning signs	Abdominal pain; Persistent vomiting; Clinical fluid accumulation; Mucosal bleeding; Hepatomegaly (> 2 cm); ↑ in hematocrit; rapid ↓ of platelet	DHF I-IV and severe dengue	Nil	1 warning sign: DHF I-IV 79%. DHF II-IV 100%. Severe dengue 100%. 2 warning signs: DHF I-IV 33%, DHF II-IV 47%, Severe dengue 46%. 3 warning signs: DHF I-IV 6%, DHF II-IV 9%, Severe dengue 8%	1 warning sign: DHF I-IV 52%, DHF II-IV 52%, Severe dengue 48%. 2 warning signs: DHF I-IV 88%, DHF II-IV 88%, Severe dengue 85%. 3 warning signs: DHF I-IV 99%, DHF II-IV 99%, Severe dengue 98%
Chi et al[38], 2023	Multivariable binary logistic regression	Clinical presentations; age; chronic comorbidities, such as DM, CKD, chronic heart failure, and neoplasms; and abnormal laboratory finding	Critical outcomes early identification and treatment	4	95.7%	76.8%
Lee et al[27], 2018	Regression equation	Serum bicarbonate; ALT; age; gender	Mortality	2	94.9%	85.2%
Suwarto et al[30], 2018	Nomogram	Hct; Serum Albumin; Platelet count; AST ratio	Pleural effusion and/or ascites	≥ 2	92.45	74.26
Huang et al[35], 2017	Nomogram	Elderly age (≥ 65 years); Hypotension (systolic blood pressure < 90 mmHg); hemoptysis; DM; chronic bedridden	Mortality	1 and 3	Score ≥ 1: 91.2%	Score ≥ 3: 99.7%
Sachdev et al[13], 2021	Outcome predictor variables	SGPT; S lactate; PRISM 12 (paediatric risk of mortality at 12 hours admission); VIS (vasopressor inotrope score); FB (fluid balance % at 24 hours)	Mortality	S lactate: 2.73 mmol/L, VIS: 22.5	S lactate: 0.90	VIS: 0.948
Pang et al[36], 2014	Prognostic index (equation)	Neutrophil proportion; ALT; serum urea level	ICU requirement	P = −1.4	88.2	88.9
Nguyen et al[16], 2017	Nomogram	Vomiting; PLT; n × AST ULN; NS1 +ve	Severe Dengue	Nil	0.87	0.88
Gayathri et al[10], 2023	Binary logistic regression	Bedside dengue severity score = -1.297 + 4.234 (narrow pulse pressure) + 1.284 (mucosal bleed) + 0.489 (third space fluid loss)	Severe dengue	Nil	86.75%	98.25%
Tangnararatchakit et al[26], 2020	Nomogram	Age ≤ 1 year; aspirin or nonsteroidal drug ingestion; underlying disease such as hemolytic anaemia and congenital heart disease; additional vital signs; urine output; bleeding sites; amounts of the required crystalloid; colloid and blood components; inotropic drug administration; respiratory support and invasive procedures	Subsequent threatened shock and profound shock	≥ 12	86.21	84.26
Marois et al[24], 2021	Sex-specific multivariable predictive model	Female model: Age class; Medical history; Hypertension (treated/untreated); Symptoms-Mucosal bleeding, clinical liquid accumulation, skin rash (except purpura); last biological results-Platelets < 30 g/L, ALT > 10 N. Male model: Age class; Risky behaviour; Alcohol abuse > 3 u/day; symptoms mucosal bleeding; last biological results-Platelets < 30 g/L, ALT > 10N	Severe dengue	Nil	Female model: 84.5%. Male model: 84.5%	Female model: 78.6%. Male model: 95.5%
Bhaskar et al[12], 2022	Multivariable binary regression model	PCV; Platelet count; ALT; Highest WBC; Hypotension	Complicated dengue in paediatric patients	2	84.1	72.5
Suwarto et al[18], 2016	Nomogram	Hct; Serum Albumin; Platelet count; AST ratio	Pleural effusion/or ascites	≥ 2	82.47	70.42
Devarbhavi et al[25], 2020	MELD score	Admission lactate	Mortality	Nil	81%	74%
Park et al[14], 2018	Structural equation modelling	Any dengue illness; AST, WBC; %lymphocytes; PLT; tourniquet test at fever day -3 and -1	DF, DHF vs DSS	0.587	80.4	80.4
Fernández et al[31], 2017	Univariable and multivariable logistic regression	Headache; petechiae; ascites; platelets < 50000 platelets/mm3 at baseline	Plasma leakage	7%	76.4	70.3
Lee et al[32], 2016	Multivariable model based on disease duration	Model 1 age (≥ 65 years vs < 65 years); minor gastrointestinal bleeding (present vs absent); leukocytosis WBC > 10 × 109 cells/L (present vs absent); Platelet count ≥ 100 × 109 cells/L (present vs absent)	Severe dengue	1	70.3%	90.6%
Phakhounthong et al[28], 2018	CART (classification and regression tree)	HCT; GCS; urine protein; Cr; PLT	Severe dengue	0.5	0.605	0.65
Djossou et al[17], 2016	Logistic regression model	Hematocrit increase; protein concentration; sodium concentration; lymphocyte count; age; aches; extensive purpura; Rash; serous effusion; bleeding	Shock	Nil	48.2	94.2
Yang et al[37], 2023	CART and random forest model	Age; dyspnoea; plasma leakage; lowest platelet	Severe dengue	Nil	Nil	Nil
McBride et al[11], 2022	Nomogram	SpO2/FiO2; platelet count; Bilirubin level; MAP/PP; Adrenergic agents; GCS score; Creatinine and urine output	Duration of ICU admission Requirement for organ support (mechanical ventilation, vasopressors, renal replacement therapy). Duration of intravenous fluid therapy. Death	Nil	Nil	Nil
Srisuphanunt et al[23], 2022	Nomogram	Albumin; AST; ALT; PLT; PTT; DENV IgM	Severe dengue	Nil	Nil	Nil
Md-Sani et al[29], 2018	Regression equation	Serum bicarbonate; ALT; age; gender	Mortality	Nil	Nil	Nil
Hsieh et al[15], 2017	Multivariate Cox model	APTT; SOFA; APACHE II scores	Mortality	Nil	Nil	Nil
Lam et al[19], 2015	Nomogram	Age; day of illness; pulse rate; temperature; hematocrit; hemodynamic index	Profound DSS, Recurrent shock	Nil	Nil	Nil
Pongpan et al[33], 2014	Nomogram	Age; Hepatomegaly; SBP; WBC; PLT	DF, DHF vs DSS	Nil	Nil	Nil
Pongpan et al[34], 2013	Nomogram	Age; Hepatomegaly; HCT; SBP; WBC; PLT	DF, DHF vs DSS	Nil	Nil	Nil
Diaz-Quijano et al[21], 2010	Binomial regression	Age between 12 and 45 years, rash; vomiting; temperature > 38 °C; leukocyte count < 4500/L; platelet count < 90.000/L	Bleeding	Nil	Nil	Nil
Potts et al[22], 2010	CART	(1) WBC; %monocytes; PLT; HCT; and (2) WBC; AST; %neutrophil; PLT; Age	Severe Dengue (DSS vs DHF Grade 3/4, or PEI > 15)	Nil	Nil	Nil

ALT: Alanine transaminase; AST: Aspartate aminotransferase; DF: Dengue fever; DHF: Dengue haemorrhagic fever; DSS: Dengue shock syndrome; GCS: Glasgow coma scale; HCT: Haemotocrit; MAP: Mean arterial pressure; PLT: Platelet; PP: Pulse pressure; SGPT: Former alanine transaminase; SOFA: Sequential organ failure assessment; ULN: Upper limit of normal; WBC: White blood cell; PEI: Pleural effusion index.