Assessment of Abnormal Liver Function Tests in Dengue Fever: Implications for Disease Severity and Outcome

Background and Objective: Dengue fever, a significant tropical disease, often presents with liver dysfunction. This study evaluated the association between elevated liver function tests (AST, ALT, bilirubin) and clinical outcomes and mortality, to identify prognostic indicators. Material & Methods: This cross-sectional study was conducted in the department of Medicine, Nishtar Hospital, Multan, over a 15-month period from July 2024 to September 2024. Patients with confirmed dengue fever were enrolled using a non-probability consecutive sampling technique. Statistical analysis was performed using SPSS version 26.0. Results: A total of 146 patients were included, with a mean age of 48 ± 17 years; the most common age group was 31 to 45 years (32%). Males constituted 78 (53%) of the sample. Dengue fever (DF) was identified in 85 (58%), dengue hemorrhagic fever (DHF) in 37 (25%) and dengue shock syndrome (DSS) in 24 (16%). AST and ALT levels were significantly elevated in DSS (670.4 ± 701.5 U/L and 700.8 ± 750.3 U/L) compared to DHF (550.7 ± 660.3 U/L and 560.4 ± 720.8 U/L) and DF (482.8 ± 645.6 U/L and 496.1 ± 683.1 U/L) (p < 0.001). Mortality was 38% in DSS and 11% in DHF (p<0.001). AST, ALT, and bilirubin were significantly higher in non-survivors (p<0.001). Severe liver dysfunction (AST + ALT > 300 U/L) was associated with increased mortality. Conclusion: This study highlights the strong association of elevated LFTs with severe dengue outcomes, underscoring their prognostic value in assessing severity and guiding interventions.