Utility of warning signs in guiding admission and predicting severe disease in adult dengue

BMC Infectious Diseases

Table 4 Performance of individual warning signs in predicting DHF and SD in outpatients

Warning sign	DHF I-IV (N = 70)				DHF II-IV (N = 43)				SD (N = 13)
	Sn	Sp	PPV	NPV	Sn	Sp	PPV	NPV	Sn	Sp	PPV	NPV
Abdominal pain (N = 88)	31	78	25	83	37	78	18	91	38	77	6	97
Persistent vomiting (N = 16)	7	96	31	82	9	96	25	89	23	96	19	97
Clinical fluid accumulation (N = 1)	1	100	100	82	0	100	0	89	0	100	0	97
Mucosal bleeding (N = 154)	61	64	28	88	100	67	28	100	62	60	5	98
Hepatomegaly (> 2 cm) (N = 2)	1	100	50	82	0	99	0	89	0	99	0	97
↑ in hematocrit; rapid ↓ of platelet (N = 10)	14	100	100	84	9	98	40	89	31	98	40	98
Any warning sign (N = 203)	79	52	27	91	100	52	21	100	100	48	6	100
Two warning signs (N = 61)	33	88	38	85	47	88	33	93	46	85	10	98
Three warning signs (N = 7)	6	99	57	82	9	99	57	89	8	98	14	97

Numbers indicated are percentages.
Sn sensitivity, Sp specificity, PPV Positive predictive value, NPV Negative predictive value.
Combinations of two warning signs include: Abdominal pain and mucosal bleeding; Abdominal pain and persistent vomiting; Abdominal pain and hepatomegaly; Abdominal pain and clinical fluid accumulation; Mucosal bleeding and persistent vomiting; Mucosal bleeding and hepatomegaly; Mucosal bleeding and change in hematocrit level; Abdominal pain and change in hematocrit level.
Combinations of three warning signs include: Abdominal pain, mucosal bleeding and persistent vomiting; Abdominal pain, mucosal bleeding and change in hematocrit level.
WS Warning signs, DHF dengue hemorrhagic fever, SD severe dengue.

ISSN: 1471-2334