Association of Hematocrit and Thrombocyte Concentration with Hypoalbuminemia in Patient with Dengue Infection

Suhendro Suwarto
Journal article eJournal Kedokteran Indonesia • December 2017 Indonesia


Hypoalbuminemia is the hallmark of plasma leakage in patients with dengue infection. However, serum albumin measurement is not routinely performed. This study was conducted to determine the role of hematocrit and thrombocyte concentration as a predictor of hypoalbuminemia in dengue infection. This retrospective study was conducted in private hospital in Jakarta from January 2015 until June 2016. Patients older than 17 years old who were infected with dengue were included in this study. Subjects were classified as dengue infection with hypoalbuminemia and without hypoalbuminemia. Mann-Whitney test was performed to analyze the different concentration of hematocrit and thrombocyte in both group. The area under the curve was used to determine the optimal cut-off point of hematocrit and thrombocyte concentration in predicting hypoalbuminemia. Multivariate analysis was used to analyze the association of hematocrit and thrombocyte concentration with the two dengue groups. One hundred and twenty patients with dengue infection were included in this study, in which 50 patients (41.7%) were women and 70 patients (58.3%) were men. Thirty nine patients (32.5%) without hypoalbuminemia and 81 (67.5%) patients had hypoalbuminemia. Hemoconcentration with a cut-off point of ≥9.77% had an accuracy of 67.8% (95% confidence interval (CI), 58.2−77.4), with a sensitivity of 72.8%, and specificity of 46.2% in predicting hypoalbuminemia. Thrombocyte levels with a cutoff point of ≤44×103/μL had an accuracy of 80% (95% CI, 71.7−88.4), with a sensitivity of 70%, and specificity of 74.4% in predicting hypoalbuminemia. Multivariate analysis showed that thrombocyte concentration ≤44×103/μL was a predictor of hypoalbuminemia with an odd ratio (OR) of 6.49 (95% CI, 2.75−15.34). In conclusion, thrombocytopenia in patients with dengue infection is a predictor for hypoalbuminemia.




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