Dengue Fever: Clinical features and health outcomes in patients presenting to a tertiary care hospital

TL;DR

This study examines dengue fever patients in a hospital, finding a 3.8% mortality rate linked to factors like antibiotic use and elevated bilirubin.

Contribution

The study identifies antibiotic use and elevated bilirubin as independent predictors of mortality in dengue fever patients.

Findings

Mortality rate was 3.8% with significant risk factors including ischaemic heart disease and chronic kidney disease.

Elevated bilirubin levels and antibiotic use were independent predictors of mortality in dengue patients.

Clinical features like fever, headache, and multi-organ involvement were common in dengue cases.

Abstract

This study aimed to assess the mortality rate and related factors in dengue fever (DF) patients. Additionally, it will outline the clinical and biochemical characteristics and treatments administered to confirmed cases.

This retrospective cross-sectional study included DF patients who presented to Sultan Qaboos University Hospital between January 2022 and July 2023. Data were extracted from the hospital's electronic system into a pre-designed Excel data collection sheet and analysed.

The study identified 319 confirmed DF cases with male predominance. The overall mortality rate was 3.8% (n = 12). Mortality was significantly higher among those with ischaemic heart disease (41.7%; n = 5), chronic kidney disease (25%; n = 3) and those on aspirin (25%; n = 3). Patients presenting with fever, headache, arthralgia and body aches, along with multi-organ involvement, exhibited confusion, lower platelet counts, abnormalities in haematocrit and haemoglobin levels, as well as deranged liver and renal function. Backward stepwise multivariate regression analysis showed that the use of antibiotics (odds ratio [OR] = 6.644, 95% confidence interval [CI]: 1.202–36.742; P = 0.030) and elevated bilirubin levels (OR = 1.058, 95% CI: 1.013–1.105; P = 0.011) were significant independent predictors of mortality.

This study identified a mortality rate of 3.8% among patients with DF. Elevated bilirubin levels and antibiotic use during hospitalisation are independent predictors of mortality. Therefore, it is recommended that such patients be closely monitored for potential signs, symptoms and biochemical changes to reduce the risk of mortality.