@article {Lovera:2016:0891-3668:1294,
title = "Clinical Characteristics and Risk Factors of Dengue Shock Syndrome in Children",
journal = "The Pediatric Infectious Disease Journal",
parent_itemid = "infobike://wk/inf",
publishercode ="wk",
year = "2016",
volume = "35",
number = "12",
publication date ="2016-12-01T00:00:00",
pages = "1294-1299",
itemtype = "ARTICLE",
issn = "0891-3668",
eissn = "1532-0987",
url = "https://www.ingentaconnect.com/content/wk/inf/2016/00000035/00000012/art00009",
doi = "doi:10.1097/INF.0000000000001308",
keyword = "children, risk factors, shock, dengue",
author = "Lovera, Dolores and Martinez de Cuellar, Celia and Araya, Soraya and Amarilla, Sara and Gonzalez, Nicol{\’a}s and Aguiar, Carlos and Acu{\~n}a, Julia and Arbo, Antonio",
abstract = "
Background:
Dengue shock syndrome (DSS) represents one of the most severe manifestations of dengue virus infection. The objective of the present study was to analyze the clinical and laboratory characteristics, risk factors and outcome of DSS in children. 
Methods:
Patients 
Results:
Of 471 children hospitalized with dengue,
354 patients (75%) presented with shock at admission or developed later. The mean age of patients with DSS was 10.2\textpm4 years (no difference with patients without shock), without gender preference. Rash (50% vs. 56%), myalgias (45% vs. 40%), vomiting (66% vs. 68%) and
bleeding manifestations (24% vs. 21.2%) were similar for 2 groups. Similarly, there was no difference in the frequency of DSS between primary versus secondary infection cases (76.2% vs. 71.6%, P = 0.3). Age group >5 years [odds ratio (OR) 1.6, 95% confidence interval (CI): 12.8,
P P = 0.006), an activated partial thromboplastin time prolonged (OR 4; 95% CI: 1.610, P P = 0.02) were found significantly
associated with DSS. About 12% of patients required intensive care unit admission, and 2 patients died (lethality 0.35%). 
Conclusions:
This study validated most of the clinical variables present in the current WHO guidelines as markers of severe disease and add additional
variables that can help to predict the risk of progression to shock.",
}