Table 3 Definition of warning signs
Warning signs | Physicians (186) Frequency (Percent) | Nurses (285) Frequency (Percent) | P-value |
|---|---|---|---|
Abdominal pain | |||
 Abdominal tenderness | 85 (45.7) | 93 (32.6) | 0.005 |
 Continuous abdominal pain | 93 (50.0) | 107 (37.5) | 0.007 |
 Increasing pain | 70 (37.6) | 132 (46.3) | 0.06 |
 Do not know/Not sure | 7 (3.8) | 47 (16.5) | < 0.0001 |
Persistent vomiting | |||
 ≥ 6 episodes of vomiting in 24 h | 37 (19.9) | 51 (17.9) | 0.6 |
 ≥ 5 episodes of vomiting in 24 h | 29 (15.6) | 28 (9.8) | 0.06 |
 ≥ 3 episodes of vomiting in 1 h | 52 (28.0) | 82 (28.8) | 0.9 |
 Vomiting for ≥ 2 consecutive days | 46 (27.4) | 103 (36.1) | 0.05 |
 Vomiting with signs of dehydration on physical examination | 55 (29.6) | 79 (27.7) | 0.7 |
 Vomiting whenever eating/drinking | 45 (24.2) | 55 (19.3) | 0.2 |
 Do not know/Not sure | 17 (9.1) | 40 (14.0) | 0.1 |
Mucosal bleeding | |||
 Epistaxis | 149 (80.1) | 199 (69.8) | 0.01 |
 Gingival bleeding | 149 (80.1) | 237 (83.2) | 0.4 |
 Hematemesis, Melena | 123 (66.1) | 172 (60.4) | 0.2 |
 Hemoptysis | 58 (31.2) | 46 (16.1) | 0.0001 |
 Ear bleeding | 42 (22.6) | 36 (12.6) | 0.004 |
 Hematuria | 94 (50.5) | 72 (25.3) | < 0.0001 |
 Menorrhagia, metrorrhagia, vaginal bleeding | 116 (62.4) | 152 (53.3) |  |
 Petechia, purpura, ecchymosis, bruises | 72 (38.7) | 154 (54.0) | 0.05 |
 Conjunctival, subconjunctival, retinal hemorrhages | 108 (58.1) | 138 (48.4) | 0.03 |
Plasma leakage | |||
 Hemoconcentration | 162 (87.1) | 218 (76.5) | 0.005 |
 Pleural effusion | 130 (69.9) | 157 (55.1) | 0.001 |
 Gall bladder thickening | 95 (51.1) | 64 (22.5) | < 0.0001 |
 Ascites | 101 (54.3) | 97 (34.0) | < 0.0001 |
 Edema (face and extremities) | 64 (34.4) | 66 (23.2) | 0.009 |
 Free fluids around the urinary bladder | – | – |  |
 Do not know/Not sure | 4 (2.2) | 26 (9.1) | 0.003 |
Liver enlargement | |||
 Liver edge palpated more than 2 cm below the costal margin | 107 (57.5) | 129 (45.3) | 0.009 |
 Liver edge palpated below the costal margin | 33 (17.7) | 81 (28.4) | 0.008 |
 Painful hepatomegaly | 120 (64.5) | 151 (53.0) | 0.01 |
 Depend on each case | 27 (14.5) | 70 (24.6) | 0.008 |
Hemoconcentration | |||
 Increasing in hematocrit by more than 20% from the baseline | 133 (72.7) | 158 (57.5) | 0.0008 |
 Increasing in hematocrit by more than 15% from the baseline | 15 (8.2) | 25 (9.1) | 0.7 |
 Using a cutoff value for hematocrit that is adjusted for gender | 11 (6.0) | 12 (4.4) | 0.4 |
 Using a non-adjusted cutoff value of hematocrit > 48%, with no discrimination between males and females | 10 (5.5) | 25 (9.1) | 0.1 |
 Do not know/Not sure | 14 (7.7) | 55 (20.0) | 0.0003 |
Rapid decrease in platelet count | |||
 < 20.000 mm3 (1) | 17 (9.4) | 19 (7.0) | 0.3 |
 < 50.000 mm3 (2) | 43 (23.9) | 36 (13.2) | 0.003 |
 < 100.000/ mm3 (3) | 78 (43.3) | 151 (55.5) | 0.009 |
 < 150.000/ mm3 (4) | 4 (2.2) | 12 (4.4) | 0.2 |
 Do not know/Not sure | 38 (21.1) | 54 (19.9) | 0.7 |
Lethargy | |||
 Alteration of consciousness and/or Glasgow score < 15 or Blantyre score less than 5 | 37 (20.2) | 51 (18.2) | 0.6 |
 Drowsiness and/or irritability | 92 (50.3) | 157 (56.1) | 0.2 |
 Do not know/Not sure | 54 (29.5) | 72 (25.7) | 0.3 |