Hepatitis and thrombocytopenia: markers of dengue mortality

Krishnamoorthy, Smitha; Bhatt, Arun N; Mathew, Celine Thalappillil; Ittyachen, Abraham M

doi:10.1177/0049475517691878

Cited by 8 publications

(15 citation statements)

References 31 publications

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“…5 A recent report from Kerala state of South India reported 1.76% mortality among 1308 cases of dengue. 10 From our review of literature, we have found that there are several predictors of mortality in patients with Dengue. We have excluded the common and non-specific manifestations like fever, headache, arthralgia, myalgia and abdominal pain from our analysis.…”

Section: -35mentioning

confidence: 98%

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Predictors of mortality in adult patients with dengue: a study from South India

et al. 2018

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Background: Dengue is one of the important causes of acute febrile illnesses in India. Dengue can be a fatal disease, however there are no reliable markers which can predict mortality among these patients.Methods: A prospective cross sectional study was done in patients who were admitted to a tertiary care hospital with features of dengue fever. A total of 364 patients with IgM dengue serology positive were included in the study. Relevant clinical and laboratory parameters were collected from all patients. Association between clinico-laboratory parameters with mortality was studied using appropriate statistical methods.Results: Among the 364 patients recruited in this study, 14 (3.85%) patients died. Mortality among patients with age group 18-40 years was 2.04%, in patients aged above 40 years was 7.56%. Mortality among patients with hypotension was 42.42% (14 out of 33), bleeding manifestations was 15.38% (8/52), platelets <20,000/mm3 was 10.41% (10/96), ALT >200 was 13.04% (6/46), AST>200 was 12.34% (10/81), prolonged prothrombin time was 60%(12/20), renal failure was 28%(14/50), encephalopathy was 31.57% (6/19), multi organ dysfunction syndrome(MODS) was 43.33% (13/30), acute respiratory distress syndrome (ARDS) was 45.45% (5/11), pleural effusion was 7.5% (6/80).Conclusions: The overall mortality in the present study was 3.85%. Following variables were associated with increased risk of death among the dengue patients: Age >40 years, presence of hypotension, platelets <20000 cells/mm3, ALT>200U/L, AST>200U/L, prolonged prothrombin time, presence of renal failure, encephalopathy, MODS, ARDS and bleeding tendency (p value <0.05). Early identification of factors associated with mortality can help to make appropriate decision on care required.

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Section: -35mentioning

confidence: 98%

“…This was similar to the results reported by Krishnamoorthy et al (p value = 0.015). 10 Thrombocytopenia is a marker of clinical severity as per WHO guidelines. 11,12 It was found that markedly elevated transaminases (>200U/L) showed a significant association with mortality.…”

Section: -35mentioning

confidence: 99%

Predictors of mortality in adult patients with dengue: a study from South India

et al. 2018

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“…No entanto, vale ressaltar que esse é um sinal clínico que aparece mais tardiamente sendo mais frequente em pacientes com dengue grave, demonstrando a ineficácia desse parâmetro para predizer evolução desfavorável. A baixa prevalência desse sinal no presente estudo justifica-se pelo fato de que a população avaliada foi de pacientes em potencial evolução para as formas graves da dengue (KRISHNAMOORTHY S, et al, 2017). Desde a década de 1970, a dengue era classificada em dengue indiferenciada, dengue clássica, febre hemorrágica da dengue (FHD) e síndrome do choque da dengue.…”

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Trombocitopenia como preditor de gravidade na dengue em pacientes maiores de 15 anos

et al. 2021

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Objetivo: Verificar se a trombocitopenia tem caráter preditor de gravidade na dengue em pacientes maiores de 15 anos. Métodos: Trata-se de uma revisão sistemática da literatura realizada em fevereiro de 2021, utilizando o portal da BVS Saúde. Resultados: A busca inicial resultou em 260 artigos, sendo que após a aplicação dos critérios de inclusão e exclusão foram analisados 17 artigos cuja população era composta por adultos maiores de 15 anos de ambos os sexos com diagnóstico confirmado de dengue. O número de pacientes avaliados entre os estudos variou de 32 a 22.777 (mediana: 320). A contagem de plaquetas variou entre as fases agudas e críticas da doença, mantendo-se por volta de 100.000/mm³ na fase aguda, mas atingindo valores de 51.000/mm³ na fase crítica. Cinco estudos avaliaram diferentes valores discriminatórios de plaquetas que se mostraram significativamente associados a desfechos desfavoráveis como óbito e hospitalização prolongada. Esses valores, apesar de variáveis, foram em sua maioria menores ou iguais a 50.000/mm³. Considerações finais: A trombocitopenia foi uma alteração precoce e associada a desfechos desfavoráveis, reforçando a necessidade de manter a contagem de plaquetas na estratificação de gravidade da dengue, podendo atuar inclusive como seu discriminador independente.

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“…14 In another study done by Krishnamoorthy et al the case fatality ratio was 1.8%. 15 In WHO manual, it was highlighted that, if untreated the fatality was 30 to 40% in patients with DSS. 16 It is worthwhile to note that the survival of dengue infected children is directly related to early and intensive management.…”

Section: Discussionmentioning

confidence: 99%

A study on the outbreak of dengue fever in a tertiary care children’s hospital in southern Tamil Nadu, India

Premkumar

Stephenson

Hepzibah³

et al. 2019

Int J Contemp Pediatr

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Background: Dengue fever is the most rapidly spreading mosquito-borne viral disease in the world.Incidence has increased 230-fold with increasing geographic expansion with potential for further spread. The rapidly expanding global footprint of dengue is a public health challenge with an economic burden. This study’s objective is to assess the outbreak of epidemic of dengue fever in a tertiary care children hospital and to describe their socio-demographic, clinical outcome and serological profile.Methods: It is an observational descriptive study conducted for a period of 1 year in less than 12 years old children in a tertiary care hospital at Southern Tamil Nadu.Results: Among the 360 children admitted with dengue fever, there were 198 boys (55%) and 162 (45%) were girls. Maximum incidence of dengue incidence was seen in infants less than 1 year (25%). The highest number of cases were admitted during September and October. The most common affected age group was less than 3 years with 179 (49%). Among the cases, 297 (82%) were of severe dengue which constitute dengue haemorrhagic fever-183(38%) and Dengue shock syndrome 114 (62%). Serological analysis showed NS1 Ag was positive in 144 children (40%), Dengue IgM was positive in 54 children (15%), both IgM and IgG positive in 126 children (35%) and IgG was positive in 36 children (10%). Out of the total children admitted with dengue fever, the case fatality was 0.5% (2 children).Conclusions: This study highlights the importance of WHO clinical criteria for early diagnosis of severe dengue. Moreover, the early and intensive management reduces the mortality significantly.

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Hepatitis and thrombocytopenia: markers of dengue mortality

Cited by 8 publications

References 31 publications

Predictors of mortality in adult patients with dengue: a study from South India

Predictors of mortality in adult patients with dengue: a study from South India

Trombocitopenia como preditor de gravidade na dengue em pacientes maiores de 15 anos

A study on the outbreak of dengue fever in a tertiary care children’s hospital in southern Tamil Nadu, India

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