The outcomes of patients with severe dengue admitted to intensive care units

doi:10.1097/MD.0000000000004376

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Title:	The outcomes of patients with severe dengue admitted to intensive care units
Authors:	Chen, Chin-Ming Chan, Khee-Siang Yu, Wen-Liang Cheng, Kuo-Chen Chao, Hui-Chun Yeh, Chiu-Yin Lai, Chih-Cheng
Contributors:	Chia Nan Univ Pharm & Sci, Dept Recreat & Hlth Care Management Chi Mei Med Ctr, Dept Intens Care Med Taipei Med Univ, Dept Med Chi Mei Med Ctr, Dept Internal Med Chung Hwa Univ Med Technol, Dept Safety Hlth & Environm Chi Mei Med Ctr, Dept Intens Care Med
Keywords:	dengue intensive care unit outcome india
Date:	2016-08
Issue Date:	2018-01-18 11:39:14 (UTC+8)
Publisher:	Lippincott Williams & Wilkins
Abstract:	Outcomes of adult patients with dengue infections requiring intensive care unit (ICU) admissions remain unclear. We assessed the clinical manifestations and prognostic factors of patients critically ill with severe dengue. This retrospective study was done in a tertiary referral hospital with 96 adult ICU beds. All of the patients with laboratory-confirmed severe dengue infections and admitted to the ICU were enrolled between July 31 and November 31.2015, during the large outbreak period. The medical records of all the recruited patients were reviewed for the following information: age, gender, clinical manifestations, disease severity scores, underlying conditions, laboratory examinations, and outcomes. The primary endpoint was to find the predictors of ICU mortality. During the study period, 4787 patients with dengue infections required ICU admission. One hundred forty-three (2.99%) were critically ill (mean age: 69.7 years). Hypertension (n =90. 62.9%) and diabetes mellitus (n =70, 49.0%) were the 2 most common underlying diseases. Eighty critically ill patients (55.9%) had cobacterial infections, and 33 had cobacteremia. The hematologic system failed most often, followed by thoracic and cardiovascular systems. Fever was the most common presentation (n =112; 78.3%), followed by anorexia (n =47; 32.9%) and abdominal pain (n =46; 32.2%). Overall, 33 patients died (mortality rate: 23.1%). Multivariate analysis showed that ICU mortality was significantly associated with lower Glasgow Coma Scale (GCS) scores, lower platelet counts before ICU discharge, and more organ failures. The number of severe dengue patients who require ICU admission remains high. The mortality rate was associated with lower GCS scores, lower platelet counts, and more organ failures. In addition, more than half of the critically ill dengue patients had comorbid bacterial infections.
Relation:	Medicine, v.95 n.31, e4376
Appears in Collections:	[Dept. of Recreation and Health-Care Management] Periodical Articles

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