Hematocrit and Leukocytes Show no Correlation during Dengue Hemorrhagic Fever’s Critical Phase

Agatha Evelyna Candra Widianti¹, Ronald Irwanto Natadidjaja²*

¹ Undergraduate Medical Program, Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia

² Department of Internal Medicine, Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia

Corresponding author

E-mail address: ronald@trisakti.ac.id

Abstract

Background: Plasma leakage during the early critical phase of dengue hemorrhagic fever (DHF) is characterized by increased hematocrit levels and decreased leukocyte counts. However, evidence regarding the relationship between these two hematological parameters remains inconsistent.

Objective: To determine the correlation between hematocrit levels and leukocyte counts in patients with DHF during the early critical phase.

Methods: An observational analytical study with a cross-sectional design was conducted at Budhi Asih Regional Hospital, East Jakarta, Indonesia, in November 2025. Medical records of hospitalized DHF patients who fulfilled the inclusion and exclusion criteria were collected using consecutive non-random sampling. Hematocrit levels and leukocyte counts obtained on the fourth day of fever were analyzed using Spearman’s correlation test.

Results: A total of 102 patients were included in the analysis. The median hematocrit level was 40% (range 30–56%), while the median leukocyte count was 3,000/mm³ (range 1,300–14,000/mm³). Spearman correlation analysis demonstrated a weak positive correlation (r = 0.19) that did not reach statistical significance (p = 0.056), indicating no significant correlation between hematocrit levels and leukocyte counts during the early critical phase of DHF.

Conclusions: Hematocrit levels were not significantly correlated with leukocyte counts in patients with dengue hemorrhagic fever during the early critical phase. Prospective studies with serial monitoring of hematocrit and leukocyte parameters, larger sample sizes, and better control of confounding factors are recommended to further clarify the relationship between these hematological variables.

Keywords: Dengue hemorrhagic fever; hematocrit; leukocytes; critical phase; correlation.

Abstrak

Demam Berdarah Dengue (DBD) dapat menyebabkan terjadinya kebocoran plasma pada awal fase kritikal yang termanifestasi dengan peningkatan kadar hematokrit dan penurunan jumlah leukosit. Tidak ditemukan hubungan yang konsisten antara kedua parameter hematologis ini, sehingga perlu dilakukan penelitian pendahuluan untuk melihat apakah terdapat korelasi antara hematokrit dengan leukosit pada DBD. Penelitian ini dilakukan dengan tujuan melihat korelasi antara kadar hematokrit dan jumlah leukosit pada pasien DBD di awal fase kritikal. Penelitian observasional analitik dengan desain potong lintang dan dilakukan di RSUD Budhi Asih Jakarta Timur pada November 2025. Sampel diambil secara consecutive non-random sampling dari rekam medis pasien DBD yang dirawat inap dan memenuhi kriteria inklusi dan eksklusi, kemudian dianalisis menggunakan uji korelasi Spearman untuk menguji hubungan antara kedua variabel. Dari 102 subjek, median hematokrit 40% (rentang 30–56%) dan median leukosit 3.000/mm³ (rentang 1.300–14.000/mm³). Uji korelasi Spearman menunjukkan koefisien korelasi r = 0,19 dengan nilai p=0,056, yang mengindikasikan tidak terdapat korelasi antara hematokrit dan jumlah leukosit pada awal fase kritikal DBD. Studi lanjutan perlu dilakukan dengan pemantauan hematokrit dan leukosit secara serial dengan ukuran sampel lebih besar untuk mengonfirmasi hubungan sebab-akibat dan pola perubahan keduanya. Selain itu pengendalian faktor perancu juga perlu dilakukan untuk meningkatkan kekuatan korelasi.

Kata kunci: demam berdarah dengue, hematokrit, leukosit, fase kritikal, korelasi