Thangaraja K, Heng JYJ, Basker G, Chong ST, See KC. Clinical prognostic scores for dengue fever: A systematic review. World J Meta-Anal 2025; 13(4): 112603 [DOI: 10.13105/wjma.v13.i4.112603]
Corresponding Author of This Article
Keerthana Thangaraja, Department of Medicine, Yong Loo Lin School of Medicine, 10 Medical Dr, Singapore 117597, Singapore. thangaraja.keerthana@u.nus.edu
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Meta-Anal. Dec 18, 2025; 13(4): 112603 Published online Dec 18, 2025. doi: 10.13105/wjma.v13.i4.112603
Clinical prognostic scores for dengue fever: A systematic review
Keerthana Thangaraja, Jun Yi Jonathan Heng, Gayathri Basker, Shu Ting Chong, Kay Choong See
Keerthana Thangaraja, Jun Yi Jonathan Heng, Gayathri Basker, Shu Ting Chong, Department of Medicine, Yong Loo Lin School of Medicine, Singapore 117597, Singapore
Kay Choong See, Department of Medicine, National University Hospital, Singapore 119228, Singapore
Author contributions: Thangaraja K, Heng JYJ, Basker G, Chong ST, See KC designed and performed the research; Thangaraja K, Heng JYJ, Basker G, Chong ST analysed the data and wrote the paper.
Conflict-of-interest statement: All authors declare no conflicts of interest in this paper.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Keerthana Thangaraja, Department of Medicine, Yong Loo Lin School of Medicine, 10 Medical Dr, Singapore 117597, Singapore. thangaraja.keerthana@u.nus.edu
Received: August 1, 2025 Revised: August 22, 2025 Accepted: December 5, 2025 Published online: December 18, 2025 Processing time: 139 Days and 21.6 Hours
Abstract
BACKGROUND
Clinical predictors of dengue fever are crucial for guiding timely management and avoiding life-threatening complications. While prognostic scores are available, a systematic evaluation of these tools is lacking.
AIM
To evaluate the performance and accuracy of various proposed dengue clinical prognostic scores.
METHODS
Three databases, PubMed, EMBASE and Cochrane, were searched for peer-reviewed studies published from inception to 4 September 2023. Studies either developing or validating a prognostic model relevant to dengue fever were included. A total of 29 studies (n = 17910) were included.
RESULTS
Most commonly studied outcomes were severe dengue (15 models) and mortality (8 models). For the paediatric population, Bedside Dengue Severity Score by Gayathri et al (specificity = 0.98) and the nomogram model by Nguyen et al (sensitivity = 0.87) performed better. For the adult population, the most specific model was reported by Leo et al (specificity = 0.98). The most sensitive score is shared between Warning Signs for Severe Dengue as reported by Leo et al and Model 2 by Lee et al (sensitivity = 1.00).
CONCLUSION
While several models demonstrated precision and reliability in predicting severe dengue and mortality, broader application across diverse geographic settings is needed to assess their external validity.
Core Tip: This is a comprehensive systematic review to evaluate and compare the accuracy of prognostic models in both adult and paediatric populations with dengue fever. Out of 29 included studies comprising over 17000 patients, we highlight models that demonstrated high specificity and sensitivity. Notably, the Bedside Dengue Severity Score by Gayathri et al and the nomogram by Nguyen et al performed best among paediatric models, while Leo et al’s and Lee et al’s models showed outstanding performance in adult populations. This nuanced breakdown by demographic and model performance offers actionable insights not previously synthesized in the literature.
