Aspartate Aminotransferase-to-Platelet Ratio Index (APRI) as a Novel Score in Early Detection of Complicated Dengue Fever

Abstract

Zubia Jamil,1 Samreen Khalid,1 Hafiz Muhammad Manan Haider Khan,2 Ikram Waheed,1,3 Amna Ehsan,1,3 Mohammed Alissa,4 Khalid Muhammad,5 Nayla Munawar,6 Yasir Waheed7,8 1Department of Medicine, Foundation University School of Health Sciences, Foundation University, Islamabad, 44000, Pakistan; 2Department of Rehabilitation Sciences, Shifa Tameer-E-Millat University, Islamabad, 44000, Pakistan; 3Department of Medicine, Fauji Foundation Hospital, Rawalpindi, 43600, Pakistan; 4Department of Medical Laboratory, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; 5Department of Biology, College of Science, UAE University, Al Ain, 15551, United Arab Emirates; 6Department of Chemistry, College of Science, UAE University, Al Ain, 15551, United Arab Emirates; 7Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, 1401, Lebanon; 8MEU Research Unit, Middle East University, Amman, 11831, JordanCorrespondence: Yasir Waheed, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, 1401, Lebanon, Email [email protected] Nayla Munawar, Department of Chemistry, College of Science, UAE University, Al Ain, 15551, United Arab Emirates, Email [email protected]: The occurrence of dengue fever presents a considerable burden for public health care in developing countries. This study aims to validate APRI as predictor score for severity of dengue fever so that catastrophic events could be prevented, and early triage can save lives.Methods: The retrospective cross-sectional study was done on dengue positive patients from August to November 2023. APRI score was calculated for every patient at the time of admission. The primary end-point was non-complicated disease (Simple dengue fever) vs complicated disease (dengue hemorrhagic fever and dengue shock syndrome). ROC curve was used to identify the role of APRI in prediction of dengue complication. Youden index was used to find the cut-off value of APRI along with sensitivity, specificity, positive and negative likelihood ratios. To further evaluate the role of APRI score, patients were divided into two groups, patients with APRI score greater and lesser than cut-off value. The qualitative variables among two groups were compared by chi-square testing. The predictors of complicated dengue were first determined by univariate regression analysis and then confirmed by multivariate regression analysis.Results: The mean APRI score of 135 patients was 20.06 ± 6.31. AUC for APRI score was 0.93 (p 9.04 had more DHF (20.7%) and DSS (12.6%) vs simple dengue fever (6.7%). None of the patient died with APRI 9.04.Conclusion: The APRI score, calculated at the time of admission, is an excellent marker in determining the severe dengue.Keywords: dengue, severe dengue, dengue hemorrhagic fever, aspartate aminotransferase, ROC curve, area under curve

Keywords

• dengue
• severe dengue
• dengue hemorrhagic fever
• aspartate aminotransferase
• roc curve
• area under curve