O-63 Predictive factors and early management of severe dengue fever in emergency and intensive care units in Martinique during the 2023–2024 epidemic

Methods: We conducted a retrospective, single-center observational study including all patients admitted between July 2023 and September 2024 with biologically confirmed dengue infection. Clinical, laboratory, and therapeutic data were collected. Severe dengue was defined by plasma leakage with hemodynamic failure, severe hemorrhagic manifestations, or organ dysfunction. Associations were assessed using bivariate analyses. The predictive performance of quantitative variables was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). Survival was analyzed using Kaplan-Meier curves and the log-rank test.

Results: A total of 611 patients were included (269 men, 342 women; median age 43 years [IQR 28–66]). Severe dengue occurred in 108 patients (17.7%), and 14 patients (2.2%) died. Serotype 2 was the sole circulating serotype. In addition to established risk factors, hematologic history, including but not limited to leukemias, lymphomas, myelomas, chronic anemias, and platelet disorders was significantly associated with severe dengue (p<0.001). Plasma leakage (1.8%) was strongly associated with mortality (logrank p < 0.001). Predictive performance was low for qSOFA (AUC 0.57), shock index (AUC 0.53), and initial hematocrit (AUC 0.61). Hyperlactatemia (AUC 0.72) and hypoalbuminemia (AUC 0.71) showed moderate predictive value, while thrombocytopenia demonstrated strong discrimination (AUC 0.91).

Conclusion: Severe dengue remains a life-threatening condition, particularly when plasma leakage occurs. A history of blood disorders may increase vulnerability. Early recognition and rapid hemodynamic management are critical determinants of prognosis.