Revista Costarricense de Salud Pública
Print version ISSN 1409-1429
PACHECO ACUNA, Raúl and ROMERO ZUNIGA, Juan José. Tourniquet test as predictive of spontaneous bleeding in classic dengue (den-2) cases. Rev. costarric. salud pública [online]. 2008, vol.17, n.33, pp. 19-23. ISSN 1409-1429.
Objective: To determine the significance of the tourniquet test as predictive of spontaneous bleeding in classic dengue fever patients in an DEN-2 virus outbreak. Materials and methods: A casecontrol study on 267 patients at the Dengue Unit of the Monseñor Sanabria Hospital in Puntarenas, diagnosed as classic dengue fever, between July 1999 and June 2002, during the Central Pacific Area DEN-2 virus outbreak. There were a total of 61 patients with spontaneous bleeding (cases) and 181 controls. The predictive ability of the tourniquet test, the odds ratio and the etiologic fraction were assessed using a 2x2 table, using the spontaneous bleeding condition as golden standard. Results: Sensitivity and specificity of the positive tourniquet were 41.0% and 75.1%, respectively; besides, the predictive positive value was 35.7% while the predictive negative value was 79.1%. Patients diagnosed with dengue by DEN-2 virus, with a tourniquet positive test had two times the chance of spontaneous bleeding than those with a negative test (OR= 2.1, 95% IC: 1.1-3.9). Conclusion: The tourniquet test is not reliable to predict capillary fragility; hence it should not be used to classify patients that require hospitalization in cases of dengue fever caused by DEN-2 virus.
Keywords : classical dengue; spontaneous bleeding; tourniquet test; sensitivity; specificity; predictive values.