NGHIÊN CỨU MỐI LIÊN QUAN GIỮA TỔN THƯƠNG GAN VỚI ĐẶC ĐIỂM LÂM SÀNG VÀ BIẾN CHỨNG Ở TRẺ MẮC SỐT XUẤT HUYẾT DENGUE TẠI BỆNH VIỆN NHI ĐỒNG CẦN THƠ NĂM 2024-2025

Abstract

Background: Liver injury is a common manifestation in Dengue hemorrhagic fever (DHF), with elevated liver enzymes playing a crucial role in predicting disease severity. Objective: Assess the correlation between hepatic involvement and clinical, laboratory, and complication profiles in pediatric patients with DHF. Materials and methods: 110 pediatric patients diagnosed with DHF according to the standards of the Ministry of Health in 2023, treated at Can Tho Children's Hospital. Results: The proportion of DHF cases with liver involvement was 32.7%. Among patients with liver injury, the shock rate was 41.7% with OR of 9.86 (95% CI: 3.2-30.33, p<0.001), bleeding occurred in 41.7% of patients with liver injury (OR=12.5, 95% CI: 3.74-41.75, p<0.001) and coagulopathy was observed in 38.9% (OR=6.09, 95% CI: 2.18-17.01, p=0.001). Clinical symptoms such as vomiting (63.9%) and mucosal bleeding (38.9%) were significantly more frequent in the liver injury group (p<0.001). Additionally, the presence of plasma leakage on ultrasound (44.4%) and platelet count ≤ 50.000/μL (54.8%) were significantly associated with liver injury (p<0.001). Conclusion: In the liver injury group, the incidence of shock was 41.7% (OR=9.86, p<0.001). Other complications such as bleeding and coagulopathy were also significantly more common (p<0.001). Clinical symptoms including vomiting and mucosal bleeding were more frequently observed in patients with liver injury (p<0.001). Additionally, ultrasound findings of plasma leakage and platelet count ≤ 50.000/μL were significantly associated with liver injury (p<0.001).