Dengue fever is one of the most rapidly spreading mosquito-borne viral diseases globally, affecting millions of individuals annually. While most dengue infections are self-limiting, a proportion of patients progress to severe dengue characterized by plasma leakage, severe bleeding, organ dysfunction, and shock. Early identification of predictors associated with severe outcomes is critical for timely intervention and mortality reduction.

Objective

To evaluate demographic, clinical, laboratory, and epidemiological predictors associated with severe outcomes in dengue fever and discuss their implications for clinical management and public health practice.

Methods

A comprehensive narrative review and analytical synthesis of studies published between 2015 and 2025 was conducted. Relevant literature examining predictors of severe dengue, risk stratification models, laboratory markers, and clinical outcomes was analyzed.

Results

Several predictors were consistently associated with severe dengue, including secondary infection, advanced age, comorbidities, persistent vomiting, abdominal pain, mucosal bleeding, thrombocytopenia, elevated hematocrit, liver dysfunction, and delayed healthcare presentation. Biomarkers such as serum ferritin, AST, ALT, lactate levels, and inflammatory cytokines demonstrated strong predictive value for severe disease progression.

Conclusion

Early recognition of risk factors and warning signs is essential for reducing dengue-related morbidity and mortality. Integrating clinical assessment with laboratory markers and predictive models can improve patient triage and optimize healthcare resource allocation.