Development and Validation of the Dengue Simplified Severity Score Based on the Marois Severity Score for Predicting Severe Dengue in the Emergency Department.

OBJECTIVE

To validate and simplify Marois Severity Score (MSS) for improved usability in the emergency department (ED) setting, and to compare its predictive accuracy with a newly developed Dengue Simplified Severity Score (D-SSS).

METHODS

This retrospective, observational study included adult patients presenting with laboratory-confirmed dengue to Universiti Malaya Medical Centre ED from January 2023 to December 2023. D-SSS was developed by modifying MSS. The scoring system incorporated age, hypertension, mucosal bleeding, thrombocytopenia, and elevated ALT levels. D-SSS and MSS were evaluated for accuracy in predicting severe dengue according to the World Health Organisation 2009 classification using receiver operating characteristic (ROC) analysis.

RESULTS

Of 507 eligible patients, 350 were analysed. D-SSS, with a cut-off value of 2.5, demonstrated 80.0% (95% CI: 51.91, 95.67) sensitivity and 75.5% (95% CI: 70.55, 80.03) specificity in predicting severe dengue. Its discriminative ability (AUC: 0.856) was numerically higher but not statistically different from MSS (AUC: 0.782; p = 0.335, DeLong's test).

CONCLUSIONS

D-SSS provides an accurate and more practical tool for predicting severe dengue in the ED. Its simplified design enhances applicability, facilitating earlier intervention and potentially improving patient outcomes.