Biochemical and ultrasound predictors of ICU admission among hospitalized dengue patients in Bangladesh

Abstract Background In recent years, Bangladesh has seen a rise in dengue cases, accompanied by higher hospitalization and mortality rates. This paper deals with the laboratory and ultrasound predictors of ICU admission among hospitalized dengue patients in Dhaka North City Corporation (DNCC) Dedicated COVID-19 Hospital in 2023. Methods Three hundred five serological test-positive hospitalized dengue patients were enrolled in this prospective cohort study. Upon admission, each patient was tested for several laboratory markers including Hb%, hematocrit level, platelet count, and serum SGPT level. Each patient had at least one ultrasound examination by a certified radiologist on the 1st day of admission. Patients were followed until discharge from the hospital or in-hospital death. Results and discussion In bivariate analysis, significant association was observed between ICU admission status and platelet count [ t (226.5) = 9.9, p < 0.05], hospital stay (in days) [ t (244.3) = − 18.0, p < 0.05], level of SGPT [ t (203.2) = − 4.3, p < 0.05], thickening of gall bladder (in mm) [ t (253.7) = − 12.2, p < 0.05], pleural effusion [ X 2 (1) = 71.8, p < .05], ascites [ X 2 (1) = 77.5, p < .05], organomegaly [ X 2 (1) = 24.8, p < .05], hepatic echotexture status [ p < .05], and pancreatic abnormality [ p < .05]. In the multivariable model, after adjusting of variables, a significant association was observed between ICU admission status and platelet count (aOR 0.81; 95% CI 0.72–0.91; p < 0.05), gall bladder wall thickness (aOR 1.19; 95% CI 1.06–1.34; p < 0.05), and ascites (aOR 6.05; 95% CI 2.33–15.75; p < 0.05). Conclusion In resource-limited settings like Bangladesh, triaging vulnerable patients based on laboratory and ultrasound profiles may enhance clinical management and improve patient outcomes.