Prognostic factors in severe dengue patients: A multi-center retrospective cohort study.
<h4>Background/purpose</h4>Early detection of severe dengue (SD) and appropriate management are crucial in reducing the case fatality rate. The objective of this study was to investigate the clinical characteristics of SD and identify independent risk factors associated with mortality am...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2025-01-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0012846 |
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| author | Cheng-Hsun Yang Ing-Kit Lee Yi-Chun Chen Wen-Chi Huang Jui-Chi Hsu Chien-Hsiang Tai Chung-Hao Huang Chun-Yu Lin Yen-Hsu Chen |
| author_facet | Cheng-Hsun Yang Ing-Kit Lee Yi-Chun Chen Wen-Chi Huang Jui-Chi Hsu Chien-Hsiang Tai Chung-Hao Huang Chun-Yu Lin Yen-Hsu Chen |
| author_sort | Cheng-Hsun Yang |
| collection | DOAJ |
| description | <h4>Background/purpose</h4>Early detection of severe dengue (SD) and appropriate management are crucial in reducing the case fatality rate. The objective of this study was to investigate the clinical characteristics of SD and identify independent risk factors associated with mortality among SD patients.<h4>Methods</h4>A retrospective study was conducted at two medical center hospitals between 2002 and 2019, involving patients aged ≧18 years with laboratory-confirmed SD.<h4>Results</h4>This study included 294 patients with SD, of whom 203 (69%) survived and 91 (31%) died. Among the 294 SD patients, 103 (35%) experienced acute kidney injury, 54 (18.4%) had pneumonia, and 19 (6.5%) had bacteremia. Among the 286 patients with available alanine aminotransferase (ALT) data, 41 (14.3%) experienced severe hepatitis (ALT>1000U/L). The median time from illness onset to death among the 91 SD patients who died was 5 days. Multivariable regression analysis revealed increasing odds of death associated with older age (odds ratio [OR], 1.037; 95% confidence interval [CI], 1.009-1.066), altered consciousness (OR, 8.591; 95% CI, 2.914-25.330), gastrointestinal bleeding (OR, 1.939; 95% CI, 1.037-3.626), and leukocytosis (OR, 2.504; 95% CI, 1.124-5.578) upon arrival, as well as organ impairment during hospitalization, including acute kidney injury (OR, 2.627; 95% CI, 1.373-5.028), severe hepatitis (OR, 5.324; 95% CI, 2.199-12.889), and pneumonia (OR, 2.250; 95% CI, 1.054-4.802).<h4>Conclusions</h4>Our findings underscore the importance of early recognition and intervention by frontline physicians in identifying SD patients at high risk of mortality. This information can significantly contribute to reducing fatalities and improving the overall management of SD cases. |
| format | Article |
| id | doaj-art-11e319e52bbd463abcae512fd8fc606f |
| institution | Kabale University |
| issn | 1935-2727 1935-2735 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj-art-11e319e52bbd463abcae512fd8fc606f2025-02-12T05:31:22ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352025-01-01191e001284610.1371/journal.pntd.0012846Prognostic factors in severe dengue patients: A multi-center retrospective cohort study.Cheng-Hsun YangIng-Kit LeeYi-Chun ChenWen-Chi HuangJui-Chi HsuChien-Hsiang TaiChung-Hao HuangChun-Yu LinYen-Hsu Chen<h4>Background/purpose</h4>Early detection of severe dengue (SD) and appropriate management are crucial in reducing the case fatality rate. The objective of this study was to investigate the clinical characteristics of SD and identify independent risk factors associated with mortality among SD patients.<h4>Methods</h4>A retrospective study was conducted at two medical center hospitals between 2002 and 2019, involving patients aged ≧18 years with laboratory-confirmed SD.<h4>Results</h4>This study included 294 patients with SD, of whom 203 (69%) survived and 91 (31%) died. Among the 294 SD patients, 103 (35%) experienced acute kidney injury, 54 (18.4%) had pneumonia, and 19 (6.5%) had bacteremia. Among the 286 patients with available alanine aminotransferase (ALT) data, 41 (14.3%) experienced severe hepatitis (ALT>1000U/L). The median time from illness onset to death among the 91 SD patients who died was 5 days. Multivariable regression analysis revealed increasing odds of death associated with older age (odds ratio [OR], 1.037; 95% confidence interval [CI], 1.009-1.066), altered consciousness (OR, 8.591; 95% CI, 2.914-25.330), gastrointestinal bleeding (OR, 1.939; 95% CI, 1.037-3.626), and leukocytosis (OR, 2.504; 95% CI, 1.124-5.578) upon arrival, as well as organ impairment during hospitalization, including acute kidney injury (OR, 2.627; 95% CI, 1.373-5.028), severe hepatitis (OR, 5.324; 95% CI, 2.199-12.889), and pneumonia (OR, 2.250; 95% CI, 1.054-4.802).<h4>Conclusions</h4>Our findings underscore the importance of early recognition and intervention by frontline physicians in identifying SD patients at high risk of mortality. This information can significantly contribute to reducing fatalities and improving the overall management of SD cases.https://doi.org/10.1371/journal.pntd.0012846 |
| spellingShingle | Cheng-Hsun Yang Ing-Kit Lee Yi-Chun Chen Wen-Chi Huang Jui-Chi Hsu Chien-Hsiang Tai Chung-Hao Huang Chun-Yu Lin Yen-Hsu Chen Prognostic factors in severe dengue patients: A multi-center retrospective cohort study. PLoS Neglected Tropical Diseases |
| title | Prognostic factors in severe dengue patients: A multi-center retrospective cohort study. |
| title_full | Prognostic factors in severe dengue patients: A multi-center retrospective cohort study. |
| title_fullStr | Prognostic factors in severe dengue patients: A multi-center retrospective cohort study. |
| title_full_unstemmed | Prognostic factors in severe dengue patients: A multi-center retrospective cohort study. |
| title_short | Prognostic factors in severe dengue patients: A multi-center retrospective cohort study. |
| title_sort | prognostic factors in severe dengue patients a multi center retrospective cohort study |
| url | https://doi.org/10.1371/journal.pntd.0012846 |
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