Evaluation of outcome predictors in dengue shock syndrome: A comparative study of survivors and non-survivors during the epidemic 2024 in Rawalpindi

Dengue Shock Syndrome (DSS) is a severe complication of dengue fever, leading to plasma leakage and circulatory collapse. This study investigates clinical outcomes and identifies key predictors of survival in DSS patients during the 2024 Rawalpindi epidemic. A prospective cohort study of 126 DSS patients was conducted at three hospitals in Rawalpindi, Pakistan, during the 2024 epidemic peak. Data on 27 DSS variables, including demographics, clinical and laboratory findings, and hospital stay, were analyzed. Survival outcomes were assessed using t-tests and logistic regression to identify significant predictors. The mortality rate was 26.98% in patients with DSS, reflecting the critical nature of DSS. According to current study setting, higher WBC count in CBC tests, higher levels of urea and bilirubin in renal function and liver function tests, co-morbidity, admission to MICU, pleural effusion were determined to be the key predictors of DSS outcome and were associated with higher mortality rate whereas factors like ascites showed significant association with improved survival outcome (p <0.05). For rest of the variables no significant correlation was found (p >0.05). Serological markers, including NS1, IgM, and IgG, also could not significantly predict the outcomes. The identification of seven key predictors of DSS survival underscores the need for targeted management to improve outcomes. Given the limited prognostic value of serological markers, future research should focus on early triage systems and larger multicenter studies to refine treatment protocols in resource-limited settings.