Risk Factors of Death among Children with Dengue Hemorrhagic Fever

Background: Dengue hemorrhagic fever (DHF) is still periodically around developing countries including Indonesia. Early diagnosis and adequate management may decrease either morbidity or mortality of patients with DHF. Objective: We evaluate risk factors of death in pediatric DHF patients hospitalized in Wahidin Sudirohusodo Hospital, Makassar. Methods:  We conducted a retrospective study by reviewing the medical records of children less than 18 years old hospitalized with DHF from January 2016 to December 2018. The diagnosis was based on WHO criteria and serologically positive anti-dengue Ig M or positive anti-dengue IgM and Ig G. Results: During the study period, 70 patients aged 1-17 years with the complete medical records enrolled in this study.  The DHF severity consisted of 37 cases (52.9%) with shock (DSS) and 33 cases (41. 7%) without shock and most of them were  admitted to the hospital on >3 days of fever (63 cases /90.,0%). Boys were predominantly (39/55.,7%) found than girls (31/44.,3%) and the majority of cases above 5 years (50/71,4%) with well-nourished patients in 46 cases (65.,7%).  The hematocrit level of≥ 40 mg/dl, platelets ≤ 40.000/mm3, and leukocyte ≤ 4000 mm3/l were observed in 41 cases (5.,6%), 36 cases (51.,4%), and  48 cases (68.,6%); respectively. Death was observed in four girls (5.7%) (p=0,034/OR 1,148/ 95% CI 1,003 - 1,315) with DSS because of severe conditions on admission