A Comparison of the Accuracy of Handheld Hemoglobinometer and Hematocrit Measurements for Detecting Plasma Leakage in Dengue Hemorrhagic Fever

Abstract

Purpose Practical methods for detecting plasma leakage should be readily available in all areas where dengue is endemic. We compared the accuracy of measurements obtained with a handheld HemoCue ® Hb 201 instrument used for hemoglobin point-of-care testing (Hb-POCT) with that of measurements of hematocrit (Ht) levels for detecting plasma leakage in dengue patients. Patients and Methods We performed both measurements using the HemoCue ® Hb201 system and microhematocrit method on EDTA blood taken from dengue patients at three time points during their hospitalization. Ascites, pleural effusion, or gallbladder thickening determined through ultrasound examinations were considered the gold standard for determining dengue hemorrhagic fever (DHF) versus dengue fever (DF). Results Close agreement between Hb-POCT and Ht measurements was indicated by an r square value of 0.845 in a linear regression. The sensitivity results for distinguishing between DHF and DF at admission were similar for Hb-POCT (63.6%) and Ht (66.7%) (Kappa = 0.75) using the optimal cutoff point determined via ROC analysis. Delta differences (in percentage) for Hb-POCT and Ht between the highest and lowest values showed lower sensitivity (45.5% and 48.5%, respectively; Kappa 0.60) when the optimal cutoff point was applied. Recommended cutoffs of ≥20% to confirm plasma leakage provided a slightly higher sensitivity using Hb-POCT (18.2%) compared with the sensitivity obtained using Ht (15.2%) with Kappa value of 97.9%. Conclusion Our results showed that the accuracy of Hb POCT measurements was similar and not inferior to Ht measurements for detecting plasma leakage in patients with DHF. We recommend that further evaluations are conducted to determine the optimal cutoff point given the low sensitivity associated with using ≥20% Hb-POCT or Ht increases to determine hemoconcentration.

Abnormalities in Serum Electrolytes in DF, DHF and DSS as Prognostic Indicators for Dengue Severity: A Comparative Model

“…A possible indicator of dengue hemorrhagic fever is thrombocytopenia (Hottz, Tolley, Zimmerman, Weyrich, & Bozza, 2011). Due to the concentration of plasma fluid leakage, which results in an increase in the haemoglobin weight in a unit volume of blood and hemoconcentration might be another frequent indication (Riswari et al, 2022).…”