Clinical profile, intensive care unit course, and outcome of patients admitted in intensive care unit with dengue

• Published in: Journal of critical care 2011-10, Vol.26 (5), p.449-452
• Main Authors: Juneja, Deven, DNB, FNB, Nasa, Prashant, MD, FNB, Singh, Omender, MD, FCCM, Javeri, Yash, DA, IDCC, Uniyal, Bhupesh, DA, IDCC, Dang, Rohit, MPharm
• Format: Article
• Language: English
• Subjects: Adult; APACHE; Blood platelets; Confidence intervals; Critical Care; Dengue - complications; Dengue - mortality; Dengue - therapy; Dengue fever; Dengue infection; Epidemiology; Failure; Fatalities; Female; Fever; Follow-Up Studies; Hospital Mortality; Hospitals; Humans; Illnesses; India - epidemiology; Intensive care; Intensive Care Units - statistics & numerical data; Male; Middle Aged; Mortality; Multiple Organ Failure - mortality; Multiple Organ Failure - therapy; Multiple Organ Failure - virology; Multivariate analysis; Older people; Prospective Studies; Risk Factors; Severity of Illness Index; Statistical analysis; Treatment Outcome; Young Adult
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2011.05.007

Abstract Purpose The purpose of the study was to assess the clinical profile and course of dengue patients admitted to the intensive care unit (ICU) and to identify factors related to poor outcome. Methods All patients with dengue admitted to ICU over 2.5 years were included prospectively. Severity of illness was assessed by the Acute Physiology and Chronic Health Evaluation (APACHE) II score, and organ failure was determined by the Sequential Organ Failure Assessment score. Primary outcome measure was 28-day mortality. Logistic regression analysis was performed to identify factors predicting mortality. Results Data from 198 patients were analyzed. Mean age was 39.56 ± 17.1 years, and 61.1% were male. The commonest complaints were fever (96%) and rash (37.9%). Mean admission APACHE II and Sequential Organ Failure Assessment scores were 7.52 ± 7.8 and 4.52 ± 3.4, respectively. The commonest organ failure was coagulation (43.4%) followed by respiratory failure (13.1%). Vasopressors were required by 11.6%; and dialysis and mechanical ventilation were required by 7.6% and 9.1%, respectively. Mortality was 12 (6.1%); and on multivariate analysis, APACHE II score (odds ratio, 1.781; 95% confidence interval, 0.967-3.281; P = .048) could independently predict mortality. Conclusions Patients with dengue fever may require ICU admission for organ failure. Outcome is good if appropriate aggressive care and organ support are instituted. Admission APACHE II score may predict patients at higher risk of death.