Abstract
The implementation of a laboratory information system (LIS) at the Hospital for Tropical Diseases in Thailand provides valuable medical resources, particularly for dengue. Hematocrit (Hct), which is often derived from hemoglobin (Hgb), is important in the diagnosis and management of dengue. This study aimed to evaluate the Hct value obtained from the LIS automated analyzer. We prospectively enrolled 163 hospitalized adults with dengue, for whom 1,141 real-time complete blood count (CBC) results were obtained via a hematology analyzer and updated in the LIS database. The median (interquartile range (IQR)) duration of analytic turnaround times (TATs) was 40.0 (30.0–53.0) minutes. Linear regression analysis indicated a significant relationship between Hgb and Hct with a coefficient of determination (Pearson's R2) of 0.92 at red blood cell distribution width (RDW) ≤18, but Pearson's R2 decreased to 0.78 at RDW >18. The Hct calculated from the three-fold conversion method and from the analyzer had a Pearson's R2 of 0.92. At Hgb <12 g/dl and ≥16 g/dl, a greater difference between the two Hct values was observed, with median (IQR) differences of −0.8% (−1.9%–0.2%) and 0.8% (−0.1%–1.7%), respectively (P value <0.05). In conclusion, the Hgb and Hct of patients with dengue were highly correlated at RDW ≤18. The Hct calculated from the three-fold conversion method and from the analyzer had an excellent relationship, except when the Hgb was <12 g/dl or ≥16 g/dl. Apart from routine CBC evaluation, the LIS could help for accurate data collection in clinical research and development.
Highlights
MethodsIs study was conducted according to the Declaration of Helsinki
E inclusion criteria were (1) aged at least 15 years; (2) presented with acute febrile illness defined by fever less than 7 days without organ-specific symptoms; and (3) viral dengue infection confirmed via positive results from one of the following: (a) a viral nucleic acid assay using reversetranscription polymerase chain reaction (RT-PCR), (b) a microneutralization test, or (c) dengue-specific IgM and IgG antibodies using an enzyme-linked immunosorbent assay (ELISA). e exclusion criteria were (1) a history of underlying medical illness, for example, diabetes mellitus, hematologic diseases, chronic kidney disease, or malignancy; (2) the presence of a comorbid infection, such as malaria, rickettsiosis, leptospirosis, or bacterial infection; and (3) receiving blood transfusion
Severe organ involvement due to dengue occurred in 19 patients (63.3%), dengue shock syndrome in 17 patients (56.7%), and severe clinical bleeding in 8 patients (26.7%). ere was no significant difference in dengue severity between male and female patients (Table 1)
Summary
Is study was conducted according to the Declaration of Helsinki. E protocol of this study was approved by the Ethics Committee (MUTM 2013-008-04) of the Faculty of Tropical Medicine, Mahidol University, Bangkok, ailand. Is study was conducted following the Standards for the Reporting of Observation Studies in Epidemiology (STROBE) statement [18]. Is was a prospective study that included hospitalized patients with confirmed dengue between October 2015 and January 2017. E inclusion criteria were (1) aged at least 15 years; (2) presented with acute febrile illness defined by fever less than 7 days without organ-specific symptoms; and (3) viral dengue infection confirmed via positive results from one of the following: (a) a viral nucleic acid assay using reversetranscription polymerase chain reaction (RT-PCR), (b) a microneutralization test, or (c) dengue-specific IgM and IgG antibodies using an enzyme-linked immunosorbent assay (ELISA).
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