Prevalencia y factores asociados del shock por dengue en pacientes pediátricos de 1 mes a 14 años atendidos en el Hospital de Especialidades Teodoro Maldonado Carbo durante el período 2020-2025.

Abstract

Introduction: Dengue shock represents the most clinically relevant complication within the pediatric severe dengue spectrum and constitutes a major reason for admission to intensive care units in endemic countries such as Ecuador. Local characterization of this phenomenon remains limited, particularly in tertiary care hospitals during the post-pandemic period. Objective: To estimate the prevalence of dengue shock in pediatric patients aged 1 month to 14 years admitted to the Teodoro Maldonado Carbo Specialties Hospital between 2020 and 2025, and to describe the associated clinical and epidemiological profile. Methods: an observational study with a retrospective, cross-sectional and descriptive approach was carried out through the ordered review of clinical files. The final sample comprised 105 pediatric patients with confirmed severe dengue whose records included ICD-10 code A91 together with at least one code from the R57.x or R65.x series. Statistical analysis was performed in Jamovi version 2.6.44 with frequency estimation, odds ratio calculation and binary logistic regression. Results: The overall prevalence of dengue shock in the sample was 64.8% (95% CI 55.3-73.2). Male sex predominated (50.5%) as well as the 10 to 14 years age group (54.3%). Positive IgG serological antecedent showed the largest magnitude of association with shock development (crude OR 2.12; 95% CI 0.94-4.78; p=0.068) followed by age under 5 years (crude OR 1.96; 95% CI 0.50-7.65; p=0.324) although none reached statistical significance in the bivariate analysis. The multivariable logistic regression model adjusted for age, sex, nutritional status and serological antecedent did not identify significant independent predictors either. In-hospital mortality settled at 3.8%. Conclusions: dengue shock proved highly prevalent within the pediatric population attended at HTMC during the study period. Although the clinical and epidemiological factors examined pointed in the direction described by regional literature they did not reach statistical significance, a limitation largely tied to the modest sample size available. Taken together the findings back the development of institutional triage and hemodynamic management protocols tailored to the Ecuadorian setting alongside multicenter studies with greater statistical power.