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Purpose of the research: Now a days, majority of dengue patients with an abnormal Aspartate amino Transferase (AST) level, and a decreased blood Platelet count (PLT) is linked to the severity of dengue fever. However, just a few researchers, assessed its predictive relevance for determining the severity of dengue. Hence, we aimed to assess the diagnostic value of Aspartate Aminotransferase/Platelet count Ratio Index (APRI) for predicting dengue severity.
Methods: A prospective study done among 115 patients with confirmed dengue fever (ELISA based NS1 antigen/IgM antibody positive report) who were admitted in tertiary care hospital from June 2021 to December 2021. All patients were clinically assessed and investigated for serum transaminases and platelet count on day 1, day 4 and day 7 or on the day of discharge/ death. Data was analysed using Microsoft excel and SPSS version 21.
Results: A total of 115 patients, 76 (66.1%) males and 39 (33.9%) females, with the median age of the patients were 27 years (range from 15-45). Most of the patients (65, 56.5%) had dengue fever without warning signs and 20 patients (17.4%) had severe dengue disease. The aspartate aminotransferase (AST), leukocyte count, Platelet count (PLT), aspartate Aminotransferase/Platelet count Ratio Index (APRI) showed a significant association with severe dengue (p<0.05). With the observed 2.5 cut off value, we found the sensitivity and specificity of APRI for prediction of dengue severity as 80.0%and 76.8% respectively.
Conclusion: Our study revealed that Aspartate aminotransferase/Platelet count Ratio Index (APRI), can be useful for clinicians to predict the severity of dengue fever infection during the onset of symptoms and course of treatment for better outcome.