Background

Dengue fever is one of the most important mosquito-borne viral diseases worldwide, affecting millions of individuals annually. While most infections are self-limiting, a subset of patients develop severe dengue characterized by plasma leakage, hemorrhage, organ dysfunction, and shock. Early identification of patients at risk for severe disease is essential for reducing morbidity and mortality.

Objective

To identify clinical, laboratory, and epidemiological predictors associated with severe outcomes among patients diagnosed with dengue fever.

Methods

A multicenter prospective observational study was conducted among 1,200 laboratory-confirmed dengue patients admitted to tertiary healthcare facilities. Demographic data, clinical presentations, laboratory findings, treatment details, and outcomes were analyzed to determine factors associated with severe dengue.

Results

Severe dengue occurred in 14.8% of patients. Significant predictors included persistent vomiting, abdominal pain, mucosal bleeding, thrombocytopenia, elevated hematocrit, liver dysfunction, secondary dengue infection, delayed hospital presentation, and pre-existing comorbidities. Multivariate analysis identified thrombocytopenia, elevated hematocrit, and hepatic dysfunction as the strongest independent predictors.

Conclusion

Early recognition of warning signs and laboratory abnormalities is critical for identifying patients at risk of severe dengue. Risk stratification models incorporating clinical and laboratory indicators can improve patient management and reduce dengue-related complications.