Predictors of Major Bleeding and Mortality in Dengue Infection: A Retrospective Observational Study in a Tertiary Care Centre in South India

Kevin John John; Karthik Gunasekaran; John Davis Prasad; Divya Mathew; Sohini Das; N Sultan; Asha Mary Abraham; Ramya Iyyadurai

doi:10.1155/2019/4823791

Predictors of Major Bleeding and Mortality in Dengue Infection: A Retrospective Observational Study in a Tertiary Care Centre in South India

Interdiscip Perspect Infect Dis. 2019 Sep 4:2019:4823791. doi: 10.1155/2019/4823791. eCollection 2019.

Authors

Kevin John John¹, Karthik Gunasekaran¹, John Davis Prasad¹, Divya Mathew¹, Sohini Das¹, N Sultan¹, Asha Mary Abraham², Ramya Iyyadurai¹

Affiliations

¹ Department of Medicine, Christian Medical College, Vellore 632004, Tamil Nadu, India.
² Department of Clinical Virology, Christian Medical College, Vellore 632004, Tamil Nadu, India.

Abstract

We conducted a retrospective observational study to describe the clinical profile and outcomes of patients admitted with a diagnosis of dengue fever in a tertiary hospital in South India. A total of 159 patients admitted from April 2014 to October 2018 were included in the study. Vomiting (70.4%), myalgia (60.4%), headache (42.1%), abdominal pain (38.4%), bleeding (38%), and rash (37.1%) were the most common symptoms at presentation. The mean duration of hospital stay was 4.9 days (SD ± 2.4), and the median cost was INR 19,708 ($285) (IQR INR 12,968-32,056 ($188-$305)). Major bleeding was associated with elevated SGOT and SGPT, severe dengue, and secondary dengue. Mortality was associated with elderly age; elevated total leukocyte count, serum bilirubin, serum creatinine, SGOT, and SGPT; and high SOFA score. In view of these observations, we recommend stratifying patients according to the WHO classification of dengue and avoiding the use of thrombocytopenia as a single marker of the severity of the illness.