Risk factors of GI bleeding resulting in decreased hematocrit and requiring blood products transfusion in patients admitted with dengue fever to tertiary care hospital

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Dr. Asif Mehmood, Dr. Anjum Hameed, Dr.Azka Ikram, Dr Iftikhar Ali, Muhammad Abdullah Khalid, Dr Sobia Mushtaq, Khurram Shahzad, Kashif Lodhi


Dengue Fever, Dengue hemorrhagic fever, Dengue shock syndrome, Gastrointestinal hemorrhages, INR, Dengue Complications, Dengue and Gastrointestinal bleeding, Dengue Risk Factors.


Study of various demographic and other variables in patients with GI bleeding can help give us an insight into the predictors of GI bleeding so it can be identified well in time and controlled before any fatal outcome.   

Introduction: With a sevenfold increase in incidence during the past three decades, dengue fever, though treatable, continues to remain a major epidemic with seasonal variations associated with significant morbidity and mortality in our region. [1]

Methodology: The methodology used in this study is retrospective cohort study. The data of 400 dengue patients admitted between September 2022 to November 2022 was collected, out of which 45 patients presented with or developed GI bleeding during hospital stay, chosen by the convenient sampling technique. The relative risk of bleeding is calculated with each exposure element.

Results: Among the 455 patients, 45 patients (9.8%) presented with GI bleeding, among them 35 (77.8%) were males and 10 (22.2%) were females. The bleeding mostly started on either day 5 (26.7%) or 7 (24.4%) of onset of fever. Among the risk factors calculated, during the Leaking phase, the levels of AST and ALT (>99) and INR (>1.5) predicting previous hepatic injury or hepatitis associated with dengue were the most significant risk factors with P values 0.0003, 0.0001, 0.0001 respectively.

Conclusion: According to our study the most significant risk factor of GI bleed in dengue patients in our local population are leaking phase, hepatic dysfunction evidenced by elevated AST and ALT (>99) and INR (>1.5).

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