Diagnostic Value of Novel Coupled Hematological-Biochemical Indices in Dengue Virus Infection Beyond Single-Parameter Assessment: A Pilot Study.

OBJECTIVE

Severe dengue pathogenesis involves complex interactions among hepatic injury, hemostatic failure, and endothelial dysfunction processes. This study aimed to develop and assess a panel of novel hematological-biochemical coupling indices for early risk assessment in patients with dengue virus infection.

METHOD: In this retrospective study, we analyzed 30 patients with confirmed dengue virus infection and 35 age- and sex-matched healthy controls. A set of eight composite indices was calculated from routine admission laboratory data; these comprised the Mean Platelet Volume to Platelet Count Ratio (MPR), Aspartate Aminotransferase-to-Platelet Ratio Index (APRI), Fibrosis-4 (FIB-4), Aspartate Aminotransferase-to-Lymphocyte Ratio Index (ALRI), Coagulo-Inflammatory Index (CII), Platelet-Coagulation Stress Index (PCSI), Hepato-Platelet Injury Index (HPII), and Dengue Plasma Leakage Index (DPLI). Receiver operating characteristic curve analysis and multivariable logistic regression were performed to evaluate the diagnostic accuracy and independent predictive value of each index.

RESULTS

All indices were significantly elevated in dengue patients compared to controls (p<0.001) and demonstrated excellent discriminative ability, with area under the curve values ranging from 0.846 to 1.000 (p<0.001). Notably, MPR, APRI, and PCSI showed exceptionally high odds ratios, reflecting the profound multi-system dysregulation characteristic of dengue (p<0.001).

CONCLUSION

The novel composite indices MPR, APRI, FIB-4, ALRI, CII, PCSI, HPII, and DPLI exhibit outstanding diagnostic performance for dengue virus infection.