A Cohort Study of Adult Patients with Severe Dengue in Taiwanese Intensive Care Units: The Elderly and APTT Prolongation Matter for Prognosis.
There was a large dengue outbreak in Taiwan in 2015, in which the ages of the affected individuals were higher than those in other countries. The aim of this study was to explore the characteristics and prognostic factors for adults with severe dengue in intensive care units (ICUs).All adults admitt...
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ftdoajarticles:oai:doaj.org/article:c83543d7b13b4eefb6201dda62dfe4e9 2023-05-15T15:14:56+02:00 A Cohort Study of Adult Patients with Severe Dengue in Taiwanese Intensive Care Units: The Elderly and APTT Prolongation Matter for Prognosis. Chih-Cheng Hsieh Cong-Tat Cia Jen-Chieh Lee Junne-Ming Sung Nan-Yao Lee Po-Lin Chen Te-Hui Kuo Jo-Yen Chao Wen-Chien Ko 2017-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005270 https://doaj.org/article/c83543d7b13b4eefb6201dda62dfe4e9 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5245902?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005270 https://doaj.org/article/c83543d7b13b4eefb6201dda62dfe4e9 PLoS Neglected Tropical Diseases, Vol 11, Iss 1, p e0005270 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005270 2022-12-30T22:27:34Z There was a large dengue outbreak in Taiwan in 2015, in which the ages of the affected individuals were higher than those in other countries. The aim of this study was to explore the characteristics and prognostic factors for adults with severe dengue in intensive care units (ICUs).All adults admitted to ICUs with dengue virus infection (DENV) at a medical center from July 1, 2015 to December 31, 2015 were enrolled. DENV was diagnosed by the presence of serum NS1 antigen, IgM antibodies to dengue virus, or dengue virus RNA by real-time reverse transcriptase polymerase chain reaction. Demographic data, clinical features, and lab data were collected, and a multivariate Cox model was used to identify the predictive factors for in-hospital mortality.Seventy-five patients admitted to ICUs with laboratory-confirmed DENV were enrolled (mean age 72.3±9.3 years). The most common comorbidities included hypertension (72.0%), diabetes (43.7%), and chronic kidney disease (22.7%). The in-hospital case fatality rate (CFR) was 41.3%. The patients who died were predominantly female, had higher disease severity at ICU admission, shorter ICU/hospital stay, longer initial activated partial thromboplastin time (APTT), and higher initial serum aspartate transaminase levels. Cardiac arrest before ICU admission (hazard ratio [HR]: 6.26 [1.91-20.54]), prolonged APTT (>48 seconds; HR: 3.91 [1.69-9.07]), and the presence of acute kidney injury on admission (HR: 2.48 [1.07-5.74]), were independently associated with in-hospital fatality in the Cox multivariate analysis.During the 2015 dengue outbreak in Taiwan, the patients with severe dengue in ICUs were characterized by old age, multiple comorbidities, and a high CFR. Organ failure (including cardiac failure, and renal failure) and coagulation disturbance (prolongation of initial APTT) were independent predictive factors for in-hospital fatality. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 1 e0005270 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Chih-Cheng Hsieh Cong-Tat Cia Jen-Chieh Lee Junne-Ming Sung Nan-Yao Lee Po-Lin Chen Te-Hui Kuo Jo-Yen Chao Wen-Chien Ko A Cohort Study of Adult Patients with Severe Dengue in Taiwanese Intensive Care Units: The Elderly and APTT Prolongation Matter for Prognosis. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
There was a large dengue outbreak in Taiwan in 2015, in which the ages of the affected individuals were higher than those in other countries. The aim of this study was to explore the characteristics and prognostic factors for adults with severe dengue in intensive care units (ICUs).All adults admitted to ICUs with dengue virus infection (DENV) at a medical center from July 1, 2015 to December 31, 2015 were enrolled. DENV was diagnosed by the presence of serum NS1 antigen, IgM antibodies to dengue virus, or dengue virus RNA by real-time reverse transcriptase polymerase chain reaction. Demographic data, clinical features, and lab data were collected, and a multivariate Cox model was used to identify the predictive factors for in-hospital mortality.Seventy-five patients admitted to ICUs with laboratory-confirmed DENV were enrolled (mean age 72.3±9.3 years). The most common comorbidities included hypertension (72.0%), diabetes (43.7%), and chronic kidney disease (22.7%). The in-hospital case fatality rate (CFR) was 41.3%. The patients who died were predominantly female, had higher disease severity at ICU admission, shorter ICU/hospital stay, longer initial activated partial thromboplastin time (APTT), and higher initial serum aspartate transaminase levels. Cardiac arrest before ICU admission (hazard ratio [HR]: 6.26 [1.91-20.54]), prolonged APTT (>48 seconds; HR: 3.91 [1.69-9.07]), and the presence of acute kidney injury on admission (HR: 2.48 [1.07-5.74]), were independently associated with in-hospital fatality in the Cox multivariate analysis.During the 2015 dengue outbreak in Taiwan, the patients with severe dengue in ICUs were characterized by old age, multiple comorbidities, and a high CFR. Organ failure (including cardiac failure, and renal failure) and coagulation disturbance (prolongation of initial APTT) were independent predictive factors for in-hospital fatality. |
format |
Article in Journal/Newspaper |
author |
Chih-Cheng Hsieh Cong-Tat Cia Jen-Chieh Lee Junne-Ming Sung Nan-Yao Lee Po-Lin Chen Te-Hui Kuo Jo-Yen Chao Wen-Chien Ko |
author_facet |
Chih-Cheng Hsieh Cong-Tat Cia Jen-Chieh Lee Junne-Ming Sung Nan-Yao Lee Po-Lin Chen Te-Hui Kuo Jo-Yen Chao Wen-Chien Ko |
author_sort |
Chih-Cheng Hsieh |
title |
A Cohort Study of Adult Patients with Severe Dengue in Taiwanese Intensive Care Units: The Elderly and APTT Prolongation Matter for Prognosis. |
title_short |
A Cohort Study of Adult Patients with Severe Dengue in Taiwanese Intensive Care Units: The Elderly and APTT Prolongation Matter for Prognosis. |
title_full |
A Cohort Study of Adult Patients with Severe Dengue in Taiwanese Intensive Care Units: The Elderly and APTT Prolongation Matter for Prognosis. |
title_fullStr |
A Cohort Study of Adult Patients with Severe Dengue in Taiwanese Intensive Care Units: The Elderly and APTT Prolongation Matter for Prognosis. |
title_full_unstemmed |
A Cohort Study of Adult Patients with Severe Dengue in Taiwanese Intensive Care Units: The Elderly and APTT Prolongation Matter for Prognosis. |
title_sort |
cohort study of adult patients with severe dengue in taiwanese intensive care units: the elderly and aptt prolongation matter for prognosis. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005270 https://doaj.org/article/c83543d7b13b4eefb6201dda62dfe4e9 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 1, p e0005270 (2017) |
op_relation |
http://europepmc.org/articles/PMC5245902?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005270 https://doaj.org/article/c83543d7b13b4eefb6201dda62dfe4e9 |
op_doi |
https://doi.org/10.1371/journal.pntd.0005270 |
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PLOS Neglected Tropical Diseases |
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11 |
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1 |
container_start_page |
e0005270 |
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