Background

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

Objective

This study aimed to identify clinical, laboratory, demographic, and comorbidity-related predictors associated with severe outcomes in dengue fever patients.

Methods

A retrospective multicenter study was conducted involving 3,500 laboratory-confirmed dengue patients admitted to tertiary care hospitals between 2018 and 2024. Clinical characteristics, laboratory findings, comorbidities, disease progression, and outcomes were analyzed. Multivariate logistic regression was performed to determine independent predictors of severe dengue.

Results

Severe dengue developed in 14.6% of patients. Significant predictors included advanced age, secondary dengue infection, diabetes mellitus, hypertension, persistent vomiting, abdominal pain, elevated hematocrit, thrombocytopenia, liver enzyme elevation, and delayed hospital presentation. Elevated hematocrit (OR=4.3), platelet count below 50,000/mm³ (OR=3.9), and secondary dengue infection (OR=3.6) were the strongest predictors.

Conclusion

Several clinical and laboratory parameters can predict severe outcomes in dengue fever. Early recognition of high-risk patients allows timely intervention, improved monitoring, and reduction of complications and mortality.