Predictive Analysis of Gallbladder Wall Thickness as a Marker for Bleeding Risk and Need for Transfusion in Dengue Patients.

Abstract

Increased gallbladder wall thickening (GBWT) is a manifestation of increased capillary permeability caused by severe dengue. This study was carried out to link the severity of GBWT with bleeding risk and the need for transfusion. This retrospective study included all patients diagnosed with dengue infection either via dengue nonstructural protein-1 antigen or IgM antibody. Pearson's correlation, linear regression, and receiver operating characteristic curves were used for predictive analysis of GBWT with events of bleeding and need for transfusion of platelets during the hospital stay. A total of 177 participants met the inclusion criteria; the mean age was 33.17 ± 13.63 years. Mean GBWT was found to be 0.37 ± 0.15 cm, with 46.3% of patients having a thickness greater than 0.30 cm. A total of 16 patients had bleeding events, of which 7.3% had minor bleeding and 1.7% had a major bleeding event. Linear regression analysis showed that increased GBWT was associated with decreased platelet count on admission (P = 0.002) and lowest platelet counts (P = 0.004). GBWT was found to be predictive of bleeding events and transfusion of platelets at higher sensitivity and specificity than was either platelet count on admission and lowest platelet counts.