Table 1.
Clinical characteristics and laboratory parameters of 199 patients hospitalised with severe dengue in 2014
| All (N = 199) | Died (N = 20) | Survived (N = 179) | p-value | ||||
|---|---|---|---|---|---|---|---|
| n | n(%) or median(IQR) | n | n(%) or median(IQR) | n | n(%) or median(IQR) | ||
| Age, years | 197 | 30.8 (24.7–41.3) | 20 | 43.5 (30.3–54.8) | 177 | 30.2 (23.9–38.9) | 0.0003 |
| BMI | 117 | 24.9 (21.3–29.7) | 6 | 23.6 (22.7–24.1) | 111 | 25.3 (21.3–30.0) | 0.29 |
| Gender, Male | 199 | 127 (63.8%) | 20 | 13 (65%) | 179 | 114 (63.7%) | 0.91 |
| Presence of any co-morbidity | 198 | 62 (31.2%) | 20 | 9 (45%) | 178 | 53 (29.6%) | 0.16 |
| Co-morbidity | |||||||
| COPD/BA | 9 (4.6%) | 0 (0%) | 9 (5.1%) | ||||
| DM | 24 (12.1%) | 5 (25%) | 19 (10.7%) | ||||
| Hypertension | 9 (4.6%) | 2 (10%) | 7 (3.9%) | ||||
| IHD | 2 (1%) | 1 (5%) | 1 (0.6%) | ||||
| Pregnancy | 8 (4%) | 1 (5%) | 7 (3.9%) | ||||
| Others | 10 (5.1%) | 0 (0%) | 10 (5.6%) | ||||
| Multiple co-morbidities | 198 | 20 (10.1%) | 20 | 5 (25%) | 178 | 15 (8.4%) | 0.04a |
| NS1 | 198 | 132 (66.7%) | 20 | 13 (65%) | 178 | 119 (66.9%) | 0.87 |
| High-titre IgG | 198 | 47 (23.7%) | 20 | 5 (25%) | 178 | 42 (23.6%) | 0.89 |
| IgM | 198 | 115 (58.1%) | 20 | 14 (70%) | 178 | 101 (56.7%) | 0.25 |
| Persistent vomiting | 198 | 114 (57.6%) | 20 | 14 (70%) | 178 | 100 (56.2%) | 0.24 |
| Abdominal pain | 198 | 89 (45%) | 20 | 7 (35%) | 178 | 82 (46.1%) | 0.35 |
| Lethargy | 198 | 96 (48.5%) | 20 | 15 (75%) | 178 | 81 (45.5%) | 0.01 |
| Palpable liver | 198 | 16 (8.1%) | 20 | 2 (10%) | 178 | 14 (7.9%) | 0.67a |
| Fluid accumulation | 198 | 44 (22.2%) | 20 | 4 (20%) | 178 | 40 (22.5%) | 1.00a |
| Bleed | 198 | 49 (24.8%) | 20 | 13 (65%) | 178 | 36 (20.2%) | < 0.0001a |
| Hct > 46 | 198 | 77 (38.9%) | 20 | 10 (50%) | 178 | 67 (37.6%) | 0.28 |
| Low Plt < 46 | 198 | 106 (53.5%) | 20 | 15 (75%) | 178 | 91 (51.1%) | 0.04 |
| Albumin < 34 | 198 | 106 (53.5%) | 20 | 13 (65%) | 178 | 93 (52.3%) | 0.28 |
| Number of warning signs | 199 | 20 | 179 | NSb | |||
| 0 | 9 (4.5%) | 0 (0%) | 9 (5.03%) | ||||
| 1 | 17 (8.5%) | 0 (0%) | 17 (9.5%) | ||||
| 2 | 35 (17.6%) | 2 (10%) | 33 (18.4%) | ||||
| 3 | 35 (17.6%) | 4 (20%) | 31 (17.3%) | ||||
| 4 | 49 (24.6%) | 6 (30%) | 43 (24.0%) | ||||
| 5 | 29 (14.6%) | 2 (10%) | 27 (15.1%) | ||||
| 6 | 16 (8%) | 3 (15%) | 13 (7.3%) | ||||
| 7 | 5 (2.5%) | 0 (0%) | 5 (2.8%) | ||||
| 8 | 3 (1.5%) | 2 (10%) | 1 (0.6%) | ||||
| 9 | 1 (0.5%) | 1 (5%) | 0 (0%) | ||||
| Presence of any warning signs | 198 | 190 (95.5%) | 20 | 20 (100%) | 178 | 170 (95.0%) | 1.00a |
| Severe dengue by type | |||||||
| Decompensated shock | 58 (29.1%) | 10 (50%) | 48 (26.8%) | ||||
| Compensated shock | 69 (34.7%) | 4 (20%) | 65 (36.3%) | ||||
| Respiratory compromise | 42 (21.1%) | 2 (10%) | 40 (22.3%) | ||||
| Severe bleeding | 24 (12.1%) | 10 (50%) | 14 (7.8%) | ||||
| Severe hepatitis | 40 (20.1%) | 8 (40%) | 32 (17.9%) | ||||
| AKI | 35 (17.6%) | 8 (40%) | 27 (15.1%) | ||||
| Encephalitis | 6 (3.0%) | 2 (10%) | 4 (2.2%) | ||||
| Other | 5 (2.5%) | 1 (5%) | 4 (2.2%) | ||||
| Number of types of severe dengue | NSb | ||||||
| 1 | 139 (69.8%) | 12 (60%) | 127 (70.9%) | ||||
| 2 | 53 (26.6%) | 4 (20%) | 49 (27.4%) | ||||
| 3 | 5 (2.5%) | 3 (15%) | 2 (1.1%) | ||||
| 4 | 2 (1.0%) | 1 (5%) | 1 (0.6%) | ||||
| Blood products given | 198 | 57 (28.8%) | 20 | 18 (90%) | 178 | 39 (21.9%) | < 0.0001 |
| SBP, mmHg | 198 | 103 (90–120) | 20 | 98 (87–133) | 178 | 103 (90–118) | 0.88 |
| DBP, mmHg | 198 | 63 (53–74) | 20 | 60.5 (48–84) | 178 | 63 (54–74) | 0.92 |
| MAP, mmHg | 198 | 77 (65–89) | 20 | 74.3 (61–102) | 178 | 77.3 (66–88) | 0.96 |
| PR, beats per minute | 197 | 98 (86–110) | 20 | 110 (102–120) | 177 | 96 (86–109) | 0.01 |
| Shock Index, bpm/mmHg | 197 | 1.2 (1.0–1.5) | 20 | 1.3 (1.0–1.9) | 177 | 1.2 (1.0–1.4) | 0.25 |
| RR, breaths/min | 182 | 20 (18–24) | 20 | 22 (19–30) | 162 | 20(18–23) | 0.07 |
| WBC, ×103/μL | 198 | 4.2 (2.9–5.7) | 20 | 5.3 (2.7–8.4) | 178 | 4.1 (2.9–5.6) | 0.15 |
| Hb, g/dL | 198 | 14.2(12.3–16.2) | 20 | 13.9 (11.7–17.1) | 178 | 14.2 (12.3–16.1) | 0.97 |
| Hct, % | 198 | 42 (37–47.0) | 20 | 42.5 (31.0–49.5) | 178 | 42 (37.0–47.0) | 0.91 |
| Platelet, × 103/μL | 197 | 43 (16–97) | 20 | 26 (8–41) | 177 | 53 (18–105) | 0.005 |
| Serum creatinine, μmol/L | 195 | 79 (63–101) | 20 | 110 (67–333) | 175 | 75 (63–97) | 0.01 |
| AST, U/L | 184 | 165 (66–600) | 19 | 1175 (123–1920) | 165 | 152 (63–456) | 0.01 |
| ALT, U/L | 192 | 104 (34–257) | 20 | 365 (62–755) | 172 | 95 (31–211) | 0.01 |
| Troponin T, ng/mL | 17 | 0.02 (0.009–0.3) | 6 | 0.4 (0.05–1.9) | 11 | 0.009 (0.007–0.03) | 0.10 |
| Serum bicarbonate, mmol/L | 192 | 21.1 (18.5–23.1) | 20 | 16.2 (11.2–18.8) | 172 | 21.5 (19.4–23.2) | < 0.0001 |
| Serum lactate, mmol/L | 149 | 1.6 (1.1–2.3) | 19 | 3.2 (2.1–6.5) | 130 | 1.5 (1.1–2.1) | < 0.0001 |
| Nadir WBC, × 103/μL | 198 | 2.7 (1.94–3.8) | 20 | 2.6 (2.1–4.1) | 178 | 2.7 (1.9–3.7) | 0.47 |
| Highest Hct, % | 198 | 45.1 (40.9–49.0) | 20 | 46.9 (41.0–50.2) | 178 | 45.0 (40.9–49.0) | 0.38 |
| Nadir Platelet, × 103/μL | 198 | 18 (7–44) | 20 | 7 (2–21) | 178 | 19 (8–45) | 0.005 |
| Highest serum creatinine, μmol/L | 198 | 87 (69–112) | 20 | 249 (175–378) | 178 | 83 (68–102) | < 0.0001 |
| Highest AST, U/L | 193 | 262 (100–1024) | 20 | 4763 (658–21,547) | 173 | 244 (98–589) | < 0.0001 |
| Highest ALT, U/L | 197 | 147 (58–450) | 20 | 1243 (243–3780) | 177 | 117 (55–303) | < 0.0001 |
| Highest Troponin T, ng/mL | 22 | 0.01 (0.005–0.3) | 5 | 0.7 (0.1–1.9) | 17 | 0.01 (0.005–0.03) | 0.07 |
| Lowest Serum bicarbonate, mmol/L | 195 | 19.5 (16.9–21.4) | 20 | 8.5 (6.7–13.1) | 175 | 19.9 (17.9–21.5) | < 0.0001 |
| Highest Serum lactate, mmol/L | 189 | 1.9 (1.3–2.8) | 20 | 16.0 (6.7–18.5) | 169 | 1.8 (1.2–2.3) | < 0.0001 |
| Total fluids given, mL | 193 | 6034 (3470–8707) | 20 | 9808 (7184–16,692) | 173 | 5610 (3307–8259) | 0.0004 |
n count of non-missing observations; aFisher’s exact test; bPost-hoc multiple comparisons tests using Scheffe’s method; IQR interquartile range, BMI body mass index, COPD chronic obstructive airway disease, BA bronchial asthma, DM diabetes mellitus, IHD ischemic heart disease, NS1 non-structural protein 1 antigen, SBP systolic blood pressure, DBP diastolic blood pressure, MAP mean arterial pressure, PR pulse rate, RR respiratory rate, AST aspartate transaminase, ALT alanine transaminase, WBC white blood cell count, Hct hematocrit, AKI acute kidney injury, NS not significant