Kaur Gursheen, Kumar Vipin, Puri Sandeep, Tyagi Ruchita, Singh Ashwajit, Kaur Harpreet
Department of Cardiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Department of General Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
J Family Med Prim Care. 2020 Feb 28;9(2):694-697. doi: 10.4103/jfmpc.jfmpc_605_19. eCollection 2020 Feb.
Outbreaks of dengue fever cause widespread mortality. There is a paucity of studies on predictors of morbidity and mortality in dengue. This observational study was performed to study the factors predicting adverse outcomes caused due to dengue fever thereby optimally manage the patient's to reduce mortality.
The study included a 1-year retrospective and 1-year prospective period were clinical, laboratory and outcome data of patients between 18-30 years of age, having serology proven (NS1/dengue IgM) dengue fever were recorded and analysed.
Out of 418 patients, 404 (96.64%) recovered and 14 (3.35%) expired, resulting in a 3.35% mortality rate. Platelet count did not determine the outcome in dengue patients. The shock factor was present in 45 (11.1%) patients who recovered and 10 out of 14 patients who expired (71.4%), value was statistically significant. Mean value of SGOT and SGPT in dengue patients who expired were 2865.43 and 1510.07 IU/L, respectively, which were significantly higher than the mean values of SGOT and SGPT in those who survived. Bleeding was present in 39 (9.7%) patients who recovered. Out of the 14 expired patients, bleeding was present in 5 (35.7%) which is statistically significant. Hence, on multivariate logistics analysis, bleeding, a higher SGOT and SGPT value and shock were found to be significant risk factors for mortality in dengue fever patients.
Bleeding, shock and raised SGOT and SGPT levels were identified as predictors of adverse outcomes and mortality in dengue fever. Timely identification of these risk factors and active management is important to reduce dengue-related mortality.
登革热疫情导致广泛的死亡。关于登革热发病和死亡预测因素的研究较少。进行这项观察性研究以探讨预测登革热所致不良结局的因素,从而对患者进行最佳管理以降低死亡率。
该研究包括1年回顾期和1年前瞻性观察期,记录并分析了18至30岁经血清学证实(NS1/登革热IgM)患有登革热患者的临床、实验室及结局数据。
418例患者中,404例(96.64%)康复,14例(3.35%)死亡,死亡率为3.35%。血小板计数不能决定登革热患者的结局。45例(11.1%)康复患者和14例死亡患者中的10例(71.4%)出现休克因素,差异有统计学意义。死亡的登革热患者中SGOT和SGPT的平均值分别为2865.43和1510.07 IU/L,显著高于存活患者的SGOT和SGPT平均值。39例(9.7%)康复患者出现出血。14例死亡患者中有5例(35.7%)出现出血,差异有统计学意义。因此,多因素logistic分析显示,出血、较高的SGOT和SGPT值以及休克是登革热患者死亡的重要危险因素。
出血、休克以及SGOT和SGPT水平升高被确定为登革热不良结局和死亡的预测因素。及时识别这些危险因素并积极处理对于降低登革热相关死亡率很重要。