Risk Factors for Dengue Shock Syndrome in Children Admitted in Federal Govt. Polyclinic Hospital (FGPC) Islamabad

Objective: To determine the risk factors for dengue shock syndrome in children admitted in Federal Govt. Polyclinic Hospital (FGPC) Islamabad. Methodology: A cross sectional study, conducted at Pediatric department of FGPC hospital from August 2019 to October 2019, included 102 children of less than 12 years of age. All the children with acute febrile illness, who tested positive for NS1 antigen visiting the outpatient and emergency department, admitted in Pediatric department were considered eligible for enrollment in the study. Demographic and clinical characteristics were reported and correlated with disease prognosis and clinical outcomes. Results: Out of 102 patients, 13 (12.7%) developed dengue shock syndrome (DSS). Patients with capillary refill time of more than 3 seconds were found to be 2.44 times more likely to develop dengue shock syndrome (OR=2.44, 95% CI 1.47 – 4.03, p<0.001). Similarly, patients with thrombocytopenia (platelet count less than 150x103 cells) and leukopenia (TLC less than 4000x103 cells) were found to be at increased risk of developing dengue shock syndrome as compared to others (OR=1.28, 95% CI 1.12 – 1.48, p=0.001 and OR=1.6, 95% CI 1.12 – 5.21, p=0.01 respectively). Out of 13(12.7%) patients with DSS 1 patient (7.7%) died but no mortality observed in DHF. Conclusion: Increased capillary refill time, thrombocytopenia, and leukopenia were found to be significant predictors of DSS in children with dengue fever. Early identification of these risk factors can help in timely management and potentially reduce morbidity and mortality associated with DSS.