Predictive analysis on gall bladder wall thickness as a marker for bleeding risk and need of transfusion in dengue patients.

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