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Ansari MS, Jain D, Budhiraja S. Machine-learning prediction models for any blood component transfusion in hospitalized dengue patients. Hematol Transfus Cell Ther 2023:S2531-1379(23)02584-1. [PMID: 37996385 DOI: 10.1016/j.htct.2023.09.2365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/17/2023] [Accepted: 09/05/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Blood component transfusions are a common and often necessary medical practice during the epidemics of dengue. Transfusions are required for patients when they developed severe dengue fever or thrombocytopenia of 10×109/L or less. This study therefore investigated the risk factors, performance and effectiveness of eight different machine-learning algorithms to predict blood component transfusion requirements in confirmed dengue cases admitted to hospital. The objective was to study the risk factors that can help to predict blood component transfusion needs. METHODS Eight predictive models were developed based on retrospective data from a private group of hospitals in India. A python package SHAP (SHapley Additive exPlanations) was used to explain the output of the "XGBoost" model. RESULTS Sixteen vital variables were finally selected as having the most significant effects on blood component transfusion prediction. The XGBoost model presented significantly better predictive performance (area under the curve: 0.793; 95 % confidence interval: 0.699-0.795) than the other models. CONCLUSION Predictive modelling techniques can be utilized to streamline blood component preparation procedures and can help in the triage of high-risk patients and readiness of caregivers to provide blood component transfusions when required. This study demonstrates the potential of multilayer algorithms to reasonably predict any blood component transfusion needs which may help healthcare providers make more informed decisions regarding patient care.
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Affiliation(s)
- Md Shahid Ansari
- Department of Clinical Data Analytics, Max Super Speciality Hospital, New Delhi, India
| | - Dinesh Jain
- Department of Clinical Data Analytics, Max Super Speciality Hospital, New Delhi, India.
| | - Sandeep Budhiraja
- Department of Internal Medicine, Max Super Speciality Hospital, New Delhi, India
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2
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Kaur G, Kumar V, Puri S, Tyagi R, Singh A, Kaur H. Look Out for Fever: Clinical Profile of Dengue in Young Adults in a Tertiary Care Center in North India. J Lab Physicians 2022; 15:78-83. [PMID: 37064990 PMCID: PMC10104709 DOI: 10.1055/s-0042-1751320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Abstract
Background Dengue fever (DF) is a common viral disease, clinical manifestations of which vary from influenza-like illness (DF) to life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The aim of this article was to study the clinical profile of DF in young adults.
Material and Methods This was an observational study conducted in the department of medicine over a period of 2 years (January 1, 2013—December 31, 2014). Patients aged between 18 and 30 years with serology proven (nonstructural protein 1 [NS1]/dengue immunoglobulin M [IgM]) DF were included in this study. The clinical and laboratory data was recorded and analyzed.
Results Out of 418 cases, the incidence of DF, DHF, and DSS was 87.32, 7.66, and 5.02%, respectively. The most common presentations were fever (99.76%) followed by vomiting (29.43%), pain abdomen (17.94%), myalgias (13.16%), petechial rash (12.92%), and bleeding (10.29%). Dengue NS1 and IgM antibodies were positive in 87.3% and 88.12% of the patients, respectively. Ascites, splenomegaly, hepatomegaly, pleural effusion, gall bladder wall edema, and pericardial effusion were present in 8.13, 6.94, 6.70, 5.98, 2.63, and 0.72% of the patients, respectively. Complications included bleeding (10.29%), acute respiratory distress syndrome (1.67%), myocarditis (1.44%), seizures (1.44%), hemarthrosis (0.24%), and encephalopathy (0.24%). The mortality rate was 3.35% with death of 14 patients. Shock, bleeding, and elevated serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase levels predicted adverse outcome.
Conclusion DF can present with a plethora of clinical manifestations in endemic areas. Adverse outcome is more likely if patients have elevated SGOT levels, shock, and bleeding. Continuous seroepidemiological surveillance is essential to control outbreak and minimize morbidity and mortality.
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Affiliation(s)
- Gursheen Kaur
- Department of Cardiology, Oswal Cancer Hospital, Ludhiana, Punjab, India
| | - Vipin Kumar
- Department of General Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Sandeep Puri
- Department of General Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Ruchita Tyagi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Ashwajit Singh
- Department of Skin, JSS Medical College, Mysore, Karnataka, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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3
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Saud B, Adhikari S, Maharjan L, Paudel G, Amatya N, Amatya S. An Epidemiological Prospective of Focal Outbreak of Dengue Infection in Kathmandu, Nepal. JOURNAL OF CLINICAL VIROLOGY PLUS 2022. [DOI: 10.1016/j.jcvp.2022.100063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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4
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An accurate mathematical model predicting number of dengue cases in tropics. PLoS Negl Trop Dis 2021; 15:e0009756. [PMID: 34748566 PMCID: PMC8575180 DOI: 10.1371/journal.pntd.0009756] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/24/2021] [Indexed: 11/19/2022] Open
Abstract
Dengue fever is a systemic viral infection of epidemic proportions in tropical countries. The incidence of dengue fever is ever increasing and has doubled over the last few decades. Estimated 50million new cases are detected each year and close to 10000 deaths occur each year. Epidemics are unpredictable and unprecedented. When epidemics occur, health services are over whelmed leading to overcrowding of hospitals. At present there is no evidence that dengue epidemics can be predicted. Since the breeding of the dengue mosquito is directly influenced by environmental factors, it is plausible that epidemics could be predicted using weather data. We hypothesized that there is a mathematical relationship between incidence of dengue fever and environmental factors and if such relationship exists, new cases of dengue fever in the succeeding months can be predicted using weather data of the current month. We developed a mathematical model using machine learning technique. We used Island wide dengue epidemiology data, weather data and population density in developing the model. We used incidence of dengue fever, average rain fall, humidity, wind speed, temperature and population density of each district in the model. We found that the model is able to predict the incidence of dengue fever of a given month in a given district with precision (RMSE between 18- 35.3). Further, using weather data of a given month, the number of cases of dengue in succeeding months too can be predicted with precision (RMSE 10.4-30). Health authorities can use existing weather data in predicting epidemics in the immediate future and therefore measures to prevent new cases can be taken and more importantly the authorities can prepare local authorities for outbreaks.
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Mahmood R, Benzadid MS, Weston S, Hossain A, Ahmed T, Mitra DK, Ahmed S. Dengue outbreak 2019: clinical and laboratory profiles of dengue virus infection in Dhaka city. Heliyon 2021; 7:e07183. [PMID: 34141938 PMCID: PMC8188050 DOI: 10.1016/j.heliyon.2021.e07183] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 01/17/2021] [Accepted: 05/27/2021] [Indexed: 11/29/2022] Open
Abstract
Background Dengue fever has been one of the most common mosquito-transmitted diseases in the world, affecting more than 128 countries in both tropical and subtropical regions. Bangladesh has been sufferring from dengue outbreaks almost annually since 2000, and in 2019, Bangladesh faced the worst outbreak of dengue to date. This study aimed to provide clinical and biochemical profiles of Bangladesh's dengue-infected patients. Methods This cross-sectional study was conducted from August through December 2019 in three tertiary private hospitals in Dhaka, Bangladesh. We collected information on demographic data, clinical characteristics, and laboratory profiles for 542 confirmed hospitalized acute dengue cases using a structured questionnaire. Results The average age of the enrolled patients was 26.15 years, and about 50% of patients belonged to the age group of 20–40 years. The most frequent among the prevalent clinical symptoms were fever (93.1%), abdominal pain (29.5%), skin rash (25.3%), and diarrhea (19.7%). 316 patients had some complications, such as breathing problems (41.4%), pleural effusion (38.9%), gum bleeding (11.1%), etc. More than 90% of the patients showed seropositivity for the DENV-NS1 antigen. Conclusions Over the last couple of years, dengue fever has become a major health issue for Bangladesh. To reduce the burden of this disease, timely diagnosis and prompt treatment are necessary. This analysis thus yields the clinical features, laboratory profiles, and seropositivity test results of dengue patients from Bangladesh. The research results may help clinicians understand the circumstantial diagnosis of dengue patients and facilitate early intervention.
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Affiliation(s)
- Rudbar Mahmood
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Md Shadly Benzadid
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Sophie Weston
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Ahmed Hossain
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Tanveer Ahmed
- Department of Cardiology, United Hospital Ltd, Dhaka, 1212, Bangladesh
| | - Dipak Kumar Mitra
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Shakil Ahmed
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
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6
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Archuleta S, Chia PY, Wei Y, Syed-Omar SF, Low JG, Oh HM, Fisher D, Ponnampalavanar SSL, Wijaya L, Kamarulzaman A, Lum LCS, Tambyah PA, Leo YS, Lye DC. Predictors and Clinical Outcomes of Poor Platelet Recovery in Adult Dengue With Thrombocytopenia: A Multicenter, Prospective Study. Clin Infect Dis 2021; 71:383-389. [PMID: 31626692 DOI: 10.1093/cid/ciz850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 09/15/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Platelet transfusion is common in dengue patients with thrombocytopenia. We previously showed in a randomized clinical trial that prophylactic platelet transfusion did not reduce clinical bleeding. In this study, we aimed to characterize the predictors and clinical outcomes of poor platelet recovery in transfused and nontransfused participants. METHODS We analyzed patients from the Adult Dengue Platelet Study with laboratory-confirmed dengue with ≤20 000 platelets/μL and without persistent mild bleeding or any severe bleeding in a post hoc analysis. Poor platelet recovery was defined as a platelet count of ≤20 000/μL on Day 2. We recruited 372 participants from 5 acute care hospitals located in Singapore and Malaysia between 29 April 2010 and 9 December 2014. Of these, 188 were randomly assigned to the transfusion group and 184 to the control group. RESULTS Of 360 patients, 158 had poor platelet recovery. Age, white cell count, and day of illness at study enrollment were significant predictors of poor platelet recovery after adjustment for baseline characteristics and platelet transfusion. Patients with poor platelet recovery had longer hospitalizations but no significant difference in other clinical outcomes, regardless of transfusion. We found a significant interaction between platelet recovery and transfusion; patients with poor platelet recovery were more likely to bleed if given a prophylactic platelet transfusion (odds ratio 2.34, 95% confidence interval 1.18-4.63). CONCLUSIONS Dengue patients with thrombocytopenia who were older or presented earlier and with lower white cell counts were more likely to have poor platelet recovery. In patients with poor platelet recovery, platelet transfusion does not improve outcomes and may actually increase the risk of bleeding. The mechanisms of poor platelet recovery need to be determined. CLINICAL TRIALS REGISTRATION NCT01030211.
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Affiliation(s)
- Sophia Archuleta
- Division of Infectious Diseases, National University Hospital, National University Health System, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Po Ying Chia
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.,National Centre for Infectious Diseases, Singapore.,Lee Kong Chian School of Medicine, Singapore
| | - Yuan Wei
- Singapore Clinical Research Institute, Singapore
| | | | - Jenny G Low
- Singapore General Hospital, Singapore.,Duke-NUS Graduate Medical School, Singapore
| | - Helen M Oh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Changi General Hospital, Singapore; and
| | - Dale Fisher
- Division of Infectious Diseases, National University Hospital, National University Health System, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | | | - Lucy C S Lum
- University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Paul A Tambyah
- Division of Infectious Diseases, National University Hospital, National University Health System, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yee-Sin Leo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.,National Centre for Infectious Diseases, Singapore.,Lee Kong Chian School of Medicine, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - David C Lye
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.,National Centre for Infectious Diseases, Singapore.,Lee Kong Chian School of Medicine, Singapore
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Das R, Emon MPZ, Shanu SA, Akter D, Islam MR. A Haemophilic Dengue Patient with Pleural Effusion and Earache. Cureus 2020; 12:e9572. [PMID: 32913689 PMCID: PMC7474559 DOI: 10.7759/cureus.9572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
About 2.5 billion people are living at a higher risk of dengue fever in hundreds of tropical and sub-tropical countries. Treatment of dengue fever is quite complicated and challenging because of the lack of effective treatment approaches. We herein report a rare case of a 25-year-old female with a past medical history of haemophilia A, suffering from dengue fever, pleural effusion, earache, myalgia, headache, and vomiting. Dengue was confirmed by the non-structural protein 1 (NS1) antigen and immunoglobulin M (IgM) antibody test. She had low blood pressure (80/60 mmHg), frequent vomiting, and low platelet count during hospitalization. Moreover, a genetic disorder like haemophilia with plasma leakage and earache made the patient's condition worse. However, by repeated platelet infusion, the platelet counts elevated and the patient was discharged from the hospital after nine days. Complete recovery was achieved after 27 days. This is a rare case of dengue; physicians should be aware of the severity of the disease and its management tactics. More discussion and research need to be carried out to develop an effective and optimized treatment and management options to reduce the mortality and morbidity due to dengue fever with a co-morbid disease.
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Affiliation(s)
- Rajesh Das
- Pharmacy, University of Asia Pacific, Dhaka, BGD
| | | | | | - Dilruba Akter
- Medicine, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, BGD
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8
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Mohan K, Malaiyan J, Nasimuddin S, Devasir RS, Meenakshi-Sundaram P, Selvaraj S, Krishnasamy B, Gnanadesikan S, Karthikeyan M, Kandasamy M, Jayakumar N, Elumalai D, Ra GG. Clinical profile and atypical manifestation of dengue fever cases between 2011 and 2018 in Chennai, India. J Family Med Prim Care 2020; 9:1119-1123. [PMID: 32318478 PMCID: PMC7113926 DOI: 10.4103/jfmpc.jfmpc_926_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/18/2019] [Accepted: 12/27/2019] [Indexed: 11/14/2022] Open
Abstract
Introduction: Dengue fever is a common mosquito-borne viral disease which has reached alarming size in the past few years. It is endemic in more than 100 countries and significant differences were found in clinical profile and atypical manifestation. Aim of the Study: A retrospective observational study of clinical profile and atypical manifestations in patients with dengue fever. Materials and Methods: Serum samples were collected from clinically suspected cases of dengue fever and it was confirmed by NS1 antigen, IgM, and IgG antibody by ELISA. Clinical details and atypical manifestations were recorded. Observation: During the study period, a total of 2502 patients were suspected to have dengue infection, of which 464 (18.5%) samples were found to be positive for dengue viral infection. A majority of the cases were males [268 (57%)] when compared with females [196 (42%)]. Fever was the most common clinical presentation seen in all the patients, followed by headache (78.4%), myalgia (61%), body pain (49.3%), vomiting (40%), joint pain (31.5%), dry cough (19%), nausea (14%), abdominal pain (8%), diarrhea (5.6%), retro-orbital pain (04%), burning micturition (2.4%), and rashes (0.6%). Among atypical manifestations, hepatomegaly [32 (7%)] was the most common, followed by splenomegaly [23 (5%)], bradycardia [18 (4%)], meningitis [6 (1.2%)], hemoptysis [5 (1%)], acalculous cholecystitis [4 (0.8%)], and acute pancreatitis [2 (0.4%)]. The study of hematological parameters showed thrombocytopenia was present in 179 (38.5%) patients, followed by leukopenia [77 (17%)] and raised hematocrit [29 (6.2%)]. Conclusion: During ongoing epidemics, the clinical profile and atypical manifestations in clinically suspected dengue patients should be investigated early so that severe forms can be treated promptly.
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Affiliation(s)
- Kamalraj Mohan
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Jeevan Malaiyan
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Sowmya Nasimuddin
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Ravin Sathyaseelan Devasir
- Department of General Medicine, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - PradeepRaj Meenakshi-Sundaram
- Department of General Medicine, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Santhiya Selvaraj
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Bharathi Krishnasamy
- Institute of Microbiology, Madurai Medical College, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Madurai, Tamil Nadu, India
| | - Sumathi Gnanadesikan
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Muthulakshmi Karthikeyan
- Department of Microbiology, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kancheepuram, Tamil Nadu, India
| | - Mohanakrishnan Kandasamy
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Nithyalakshmi Jayakumar
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Dhevahi Elumalai
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Gokul G Ra
- Department of General Medicine, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
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9
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Kaur G, Kumar V, Puri S, Tyagi R, Singh A, Kaur H. Predictors of dengue-related mortality in young adults in a tertiary care centre in North India. J Family Med Prim Care 2020; 9:694-697. [PMID: 32318404 PMCID: PMC7114013 DOI: 10.4103/jfmpc.jfmpc_605_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 01/09/2020] [Accepted: 01/13/2020] [Indexed: 11/04/2022] Open
Abstract
Background Outbreaks of dengue fever cause widespread mortality. There is a paucity of studies on predictors of morbidity and mortality in dengue. This observational study was performed to study the factors predicting adverse outcomes caused due to dengue fever thereby optimally manage the patient's to reduce mortality. Methods The study included a 1-year retrospective and 1-year prospective period were clinical, laboratory and outcome data of patients between 18-30 years of age, having serology proven (NS1/dengue IgM) dengue fever were recorded and analysed. Results Out of 418 patients, 404 (96.64%) recovered and 14 (3.35%) expired, resulting in a 3.35% mortality rate. Platelet count did not determine the outcome in dengue patients. The shock factor was present in 45 (11.1%) patients who recovered and 10 out of 14 patients who expired (71.4%), P value was statistically significant. Mean value of SGOT and SGPT in dengue patients who expired were 2865.43 and 1510.07 IU/L, respectively, which were significantly higher than the mean values of SGOT and SGPT in those who survived. Bleeding was present in 39 (9.7%) patients who recovered. Out of the 14 expired patients, bleeding was present in 5 (35.7%) which is statistically significant. Hence, on multivariate logistics analysis, bleeding, a higher SGOT and SGPT value and shock were found to be significant risk factors for mortality in dengue fever patients. Conclusion Bleeding, shock and raised SGOT and SGPT levels were identified as predictors of adverse outcomes and mortality in dengue fever. Timely identification of these risk factors and active management is important to reduce dengue-related mortality.
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Affiliation(s)
- Gursheen Kaur
- Department of Cardiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Vipin Kumar
- Department of General Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Sandeep Puri
- Department of General Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Ruchita Tyagi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Ashwajit Singh
- Department of General Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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10
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Perelman I, Saidenberg E, Tinmouth A, Fergusson D. Trends and outcomes in multicomponent blood transfusion: an 11-year cohort study of a large multisite academic center. Transfusion 2019; 59:1971-1987. [PMID: 30903621 DOI: 10.1111/trf.15260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/02/2019] [Accepted: 02/18/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Most studies reporting on blood component utilization overlook patients transfused with more than one type of blood product (multicomponent transfusion). These patients are of importance, as they are large consumers of blood products and likely have different characteristics and outcomes than nontransfused patients and patients transfused with only one blood component type. Our study aimed to determine the prevalence of multicomponent transfusion at a large multisite academic center, as well as the patient characteristics and outcomes associated with multicomponent transfusion. METHODS A retrospective cohort study of transfused adult inpatients at the Ottawa Hospital between 2007 and 2017 was performed. Eligible transfusions were red blood cells (RBCs), platelets, plasma, cryoprecipitate, and/or fibrinogen concentrate. Descriptive analyses were done to determine multicomponent transfusion prevalence. Patient characteristics and outcomes associated with multicomponent transfusion were assessed using multivariable regressions. RESULTS Of 55,719 adult transfused inpatient admissions, 25% received a multicomponent transfusion. Multicomponent transfusion prevalence was highest in hematology (51%), cardiac surgery (45%), and critical care (40%) patients. Multivariable regression analysis showed that compared to RBC-only transfusion, multicomponent transfusion was associated with increased odds of in-hospital mortality (odds ratio, 3.48; 95% confidence interval [CI], 3.26-3.73), greater odds of institutional discharge as opposed to discharge home (odds ratio, 1.22; 95% CI, 1.15-1.30), and a 1.58 time increase in duration of hospitalization (95% CI, 1.54-1.62). CONCLUSION Multicomponent transfusion recipients make up a large proportion of transfused patients and have poorer outcomes. It is necessary to continue studying these patients, including outcomes and transfusion appropriateness, to inform best practices.
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Affiliation(s)
- Iris Perelman
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Elianna Saidenberg
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Ottawa Hospital, Ottawa, Ontario, Canada
| | - Alan Tinmouth
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Ottawa Hospital, Ottawa, Ontario, Canada
| | - Dean Fergusson
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Ottawa Hospital, Ottawa, Ontario, Canada
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11
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Chaloemwong J, Tantiworawit A, Rattanathammethee T, Hantrakool S, Chai-Adisaksopha C, Rattarittamrong E, Norasetthada L. Useful clinical features and hematological parameters for the diagnosis of dengue infection in patients with acute febrile illness: a retrospective study. BMC HEMATOLOGY 2018; 18:20. [PMID: 30181881 PMCID: PMC6114047 DOI: 10.1186/s12878-018-0116-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 08/20/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Dengue infection patients are presented with acute febrile illness. Clinical presentations may mimic other infections. The serology for definite diagnosis is costly and inaccessible in many hospitals. We sought to identify the clinical features and hematologic parameters from a complete blood count (CBC) which distinguish dengue infection from other causes. METHODS This was a retrospective single center study from Chiang Mai University Hospital. All patients who presented with acute fever between September 2013 and July 2015 were included. The diagnosis of dengue infection must be confirmed by serology. The control groups were patients who presented with acute febrile illness without localizing signs. Clinical data and CBC results were reviewed and compared. The Chi-square test was used to compare categorical variables. The CBC parameters were analyzed using the linear mixed model. RESULTS One hundred and fifty-four dengue and 146 control patients were included. Headache, nausea, loss of appetite and bleeding diathesis were significantly symptoms in dengue patients (p < 0.05). There was some diversity in the the CBC in the dengue patients compared to the control group. Moreover, this study also identified the day of fever which these parameters were statistically significant. The dengue group had higher hemoglobin and hematocrit from day 3 to day 10 (p < 0.001), lower white blood cell count from day 1 to day 10 (p < 0.001), lower platelet count from day 3 to day 10 (p < 0.001), higher monocyte on day 1-4 (p < 0.001), higher atypical lymphocyte percentage on day 5-9 (p < 0.001) and higher eosinophil percentage on day 9-10 (p = 0.001). Furthermore, the neutrophil to lymphocyte percentage ratio of dengue group was > 1 on the first 5 days then reversed on day 6 to Day 9 but in non-dengue group, the ratio was always > 1. CONCLUSION We identified important clinical features and CBC parameters to differentiate dengue patients from other patients who had acute febrile illness from other causes. This identification could be done in local hospitals to give an accurate diagnosis, enabling further investigation to be tailored and treatment commenced earlier.
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Affiliation(s)
- Juthatip Chaloemwong
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 110 Intravaroros road, A. Muang, Chiang Mai, 50200 Thailand
| | - Adisak Tantiworawit
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 110 Intravaroros road, A. Muang, Chiang Mai, 50200 Thailand
| | - Thanawat Rattanathammethee
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 110 Intravaroros road, A. Muang, Chiang Mai, 50200 Thailand
| | - Sasinee Hantrakool
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 110 Intravaroros road, A. Muang, Chiang Mai, 50200 Thailand
| | - Chatree Chai-Adisaksopha
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 110 Intravaroros road, A. Muang, Chiang Mai, 50200 Thailand
| | - Ekarat Rattarittamrong
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 110 Intravaroros road, A. Muang, Chiang Mai, 50200 Thailand
| | - Lalita Norasetthada
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 110 Intravaroros road, A. Muang, Chiang Mai, 50200 Thailand
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Badawi A, Velummailum R, Ryoo SG, Senthinathan A, Yaghoubi S, Vasileva D, Ostermeier E, Plishka M, Soosaipillai M, Arora P. Prevalence of chronic comorbidities in dengue fever and West Nile virus: A systematic review and meta-analysis. PLoS One 2018; 13:e0200200. [PMID: 29990356 PMCID: PMC6039036 DOI: 10.1371/journal.pone.0200200] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 06/21/2018] [Indexed: 12/13/2022] Open
Abstract
Background Flavivirus diseases such as dengue fever (DENV), West Nile virus (WNV), Zika and yellow fever represent a substantial global public health concern. Preexisting chronic conditions such as cardiovascular diseases, diabetes, obesity, and asthma were thought to predict risk of progression to severe infections. Objective We aimed to quantify the frequency of chronic comorbidities in flavivirus diseases to provide an estimate for their prevalence in severe and non-severe infections and examine whether chronic diseases contribute to the increased risk of severe viral expression. Methods We conducted a comprehensive search in PubMed, Ovid MEDLINE(R), Embase and Embase Classic and grey literature databases to identify studies reporting prevalence estimates of comorbidities in flavivirus diseases. Study quality was assessed with the risk of bias tool. Age-adjusted odds ratios (ORs) were estimated for severe infection in the presence of chronic comorbidities. Results We identified 65 studies as eligible for inclusion for DENV (47 studies) and WNV (18 studies). Obesity and overweight (i.e., BMI> 25 kg/m2, prevalence: 24.5%, 95% CI: 18.6–31.6%), hypertension (17.1%, 13.3–21.8%) and diabetes (13.3%, 9.3–18.8%) were the most prevalent comorbidities in DENV. However, hypertension (45.0%, 39.1–51.0%), diabetes (24.7%, 20.2–29.8%) and heart diseases (25.6%, 19.5–32.7%) were the most prevalent in WNV. ORs of severe flavivirus diseases were about 2 to 4 in infected patients with comorbidities such as diabetes, hypertension and heart diseases. The small number of studies in JEV, YFV and Zika did not permit estimating the prevalence of comorbidities in these infections. Conclusion Higher prevalence of chronic comorbidities was found in severe cases of flavivirus diseases compared to non-severe cases. Findings of the present study may guide public health practitioners and clinicians to evaluate infection severity based on the presence of comorbidity, a critical public health measure that may avert severe disease outcome given the current dearth of clear prevention practices for some flavivirus diseases.
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Affiliation(s)
- Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, ON, Canada.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Russanthy Velummailum
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Seung Gwan Ryoo
- Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | | | - Sahar Yaghoubi
- Faculty of Science, Ryerson University, Toronto, ON, Canada
| | - Denitsa Vasileva
- Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | - Emma Ostermeier
- Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | - Mikayla Plishka
- Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | | | - Paul Arora
- National Microbiology Laboratory, Infectious Disease Prevention and Control Branch, Public Health Agency of Canada, Toronto, ON, Canada
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Badawi A, Ryoo SG, Vasileva D, Yaghoubi S. Prevalence of chronic comorbidities in chikungunya: A systematic review and meta-analysis. Int J Infect Dis 2017; 67:107-113. [PMID: 29277382 PMCID: PMC7110669 DOI: 10.1016/j.ijid.2017.12.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 01/28/2023] Open
Abstract
There is some evidence that chikungunya virus (CHIKV) disease severity is related to particular comorbidities such as obesity, diabetes, cardiac diseases, and/or asthma. No study has examined the frequency of chronic comorbidities in severe CHIKV cases. The present study is the first to systematically describe the prevalence of chronic comorbidities in CHIKV and evaluate their possible contributions to disease severity. Hypertension, diabetes and cardiac diseases were the most frequent chronic comorbidities in CHIKV patients where they present in about 30%, 20% and 15% of the cases, respectively. Severe CHIKV cases had significantly higher proportion of diabetes than non-severe cases. Patients with diabetes had about 20% higher chance to develop severe CHIKV disease compared to those with no diabetes. The findings of this study may help developing public health measures to avert the severe outcome of the infectious disease in CHIKV patients with comorbidities.
Background Epidemiologic evidence suggests that patients with chikungunya virus (CHIKV) infection may be at risk of severe disease complications when they also have comorbidities such as obesity, diabetes, cardiac diseases, and/or asthma. However, the prevalence of these co-existing medical conditions in severe CHIKV cases has not been systematically reported. Objective The aim of the present study is to conduct a systematic review and meta-analysis to describe the prevalence of chronic comorbidities in CHIKV and evaluate their possible contributions to disease severity. Methods A search strategy was developed for online databases. Search terms used were “Chikungunya” AND “Diabetes, Hypertension, Stroke, Cardiovascular Diseases, Coronary Artery Diseases, Obesity, OR Asthma”. Only 11 articles documenting the frequency of comorbidities in CHIKV were included. Meta-analyses were conducted to evaluate the overall prevalence of comorbidities in the CHIKV infection and stratify the estimates by severity. Results Among 2,773 CHIKV patients, hypertension was the most prevalent comorbidity (31.3%; 95%CI: 17.9-48.8%) followed by diabetes (20.5%; 95%CI: 12.7-31.3%), cardiac diseases (14.8%; 95%CI: 8.1-25.5%) and asthma (7.9%; 95%CI: 3.3-17.7). There was 4- to 5-fold significant increased prevalence of diabetes, hypertension and cardiac diseases in CHIKV patients over 50 years of age compared to their younger counterparts. Severe CHIKV cases had a significantly higher proportion of diabetes than non-severe cases (p < 0.05). CHIKV patients with diabetes had OR of 1.2 (95%CI: 1.05-1.48; p = 0.0135) for developing severe infection outcome compared to those with no diabetes. Conclusion Hypertension, diabetes and cardiac diseases may contribute to the severe outcome of CHIKV. Diabetic subjects may be at higher risk of severe infection. These findings may be relevant in developing public health measures and practices targeting CHIKV patients with comorbidities to avert the severe outcome of the infectious disease.
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Affiliation(s)
- Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Seung Gwan Ryoo
- Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | - Denitsa Vasileva
- Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | - Sahar Yaghoubi
- Faculty of Science, Ryerson University, Toronto, ON, Canada
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de Souza Pereira BB, Darrigo Junior LG, de Mello Costa TC, Felix AC, Simoes BP, Stracieri AB, da Silva PM, Mauad M, Machado CM. Prolonged viremia in dengue virus infection in hematopoietic stem cell transplant recipients and patients with hematological malignancies. Transpl Infect Dis 2017; 19. [DOI: 10.1111/tid.12721] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 01/28/2023]
Affiliation(s)
| | | | | | - Alvina Clara Felix
- Virology Laboratory; Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
| | - Belinda P. Simoes
- Faculty of Medicine of Ribeirão Preto; University of São Paulo; São Paulo Brazil
| | | | | | - Marcos Mauad
- HSCT Program; Amaral Carvalho Foundation; São Paulo Brazil
| | - Clarisse M. Machado
- Virology Laboratory; Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
- HSCT Program; Amaral Carvalho Foundation; São Paulo Brazil
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Lye DC, Archuleta S, Syed-Omar SF, Low JG, Oh HM, Wei Y, Fisher D, Ponnampalavanar SSL, Wijaya L, Lee LK, Ooi EE, Kamarulzaman A, Lum LC, Tambyah PA, Leo YS. Prophylactic platelet transfusion plus supportive care versus supportive care alone in adults with dengue and thrombocytopenia: a multicentre, open-label, randomised, superiority trial. Lancet 2017; 389:1611-1618. [PMID: 28283286 DOI: 10.1016/s0140-6736(17)30269-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/15/2016] [Accepted: 12/20/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Dengue is the commonest vector-borne infection worldwide. It is often associated with thrombocytopenia, and prophylactic platelet transfusion is widely used despite the dearth of robust evidence. We aimed to assess the efficacy and safety of prophylactic platelet transfusion in the prevention of bleeding in adults with dengue and thrombocytopenia. METHODS We did an open-label, randomised, superiority trial in five hospitals in Singapore and Malaysia. We recruited patients aged at least 21 years who had laboratory-confirmed dengue (confirmed or probable) and thrombocytopenia (≤20 000 platelets per μL), without persistent mild bleeding or any severe bleeding. Patients were assigned (1:1), with randomly permuted block sizes of four or six and stratified by centre, to receive prophylactic platelet transfusion in addition to supportive care (transfusion group) or supportive care alone (control group). In the transfusion group, 4 units of pooled platelets were given each day when platelet count was 20 000 per μL or lower; supportive care consisted of bed rest, fluid therapy, and fever and pain medications. The primary endpoint was clinical bleeding (excluding petechiae) by study day 7 or hospital discharge (whichever was earlier), analysed by intention to treat. Safety outcomes were analysed according to the actual treatment received. This study was registered with ClinicalTrials.gov, number NCT01030211, and is completed. FINDINGS Between April 29, 2010, and Dec 9, 2014, we randomly assigned 372 patients to the transfusion group (n=188) or the control group (n=184). The intention-to-treat analysis included 187 patients in the transfusion group (one patient was withdrawn immediately) and 182 in the control group (one was withdrawn immediately and one did not have confirmed or probable dengue). Clinical bleeding by day 7 or hospital discharge occurred in 40 (21%) patients in the transfusion group and 48 (26%) patients in the control group (risk difference -4·98% [95% CI -15·08 to 5·34]; relative risk 0·81 [95% CI 0·56 to 1·17]; p=0·16). 13 adverse events occurred in the transfusion group and two occurred in the control group (5·81% [-4·42 to 16·01]; 6·26 [1·43 to 27·34]; p=0·0064). Adverse events that were possibly, probably, or definitely related to transfusion included three cases of urticaria, one maculopapular rash, one pruritus, and one chest pain, as well as one case each of anaphylaxis, transfusion-related acute lung injury, and fluid overload that resulted in serious adverse events. No death was reported. INTERPRETATION In adult patients with dengue and thrombocytopenia, prophylactic platelet transfusion was not superior to supportive care in preventing bleeding, and might be associated with adverse events. FUNDING National Medical Research Council, Singapore.
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Affiliation(s)
- David C Lye
- Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Sophia Archuleta
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Infectious Diseases, National University Hospital, National University Health System, Singapore
| | | | - Jenny G Low
- Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Helen M Oh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Changi General Hospital, Singapore
| | - Yuan Wei
- Singapore Clinical Research Institute, Singapore
| | - Dale Fisher
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Infectious Diseases, National University Hospital, National University Health System, Singapore
| | | | | | - Linda K Lee
- Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore
| | | | | | - Lucy C Lum
- University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Paul A Tambyah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Infectious Diseases, National University Hospital, National University Health System, Singapore
| | - Yee-Sin Leo
- Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, Singapore
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Affiliation(s)
- J. E. Levi
- Hospital Israelita Albert Einstein; São Paulo Brazil
- Fundação Pró-Sangue/Hemocentro de São Paulo; São Paulo Brazil
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Suwarto S, Nainggolan L, Sinto R, Effendi B, Ibrahim E, Suryamin M, Sasmono RT. Dengue score: a proposed diagnostic predictor for pleural effusion and/or ascites in adults with dengue infection. BMC Infect Dis 2016; 16:322. [PMID: 27391122 PMCID: PMC4938904 DOI: 10.1186/s12879-016-1671-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 06/10/2016] [Indexed: 12/31/2022] Open
Abstract
Background There are several limitations in diagnosing plasma leakage using the World Health Organization (WHO) guidelines of dengue hemorrhagic fever. We conducted a study to develop a dengue scoring system to predict pleural effusion and/or ascites using routine laboratory parameters. Methods A prospective observational study was carried out at Cipto Mangunkusumo Hospital and Persahabatan Hospital, Jakarta, Indonesia. Dengue-infected adults admitted on the third febrile day from March, 2010 through August, 2015 were included in the study. A multivariate analysis was conducted to determine the independent diagnostic predictors of pleural effusion and/or ascites and to convert the prediction model into a scoring system. Results A total of 172 dengue-infected adults were enrolled in the study. Of the 172 patients, 101 (58.7 %) developed pleural effusion and/or ascites. A multivariate analysis was conducted to determine the independent diagnostic predictors of pleural effusion and/or ascites in dengue-infected adults. The predictors were scored based on the following calculations: hemoconcentration ≥15.1 % had a score of 1 (OR, 3.11; 95 % CI, 1.41–6.88), lowest albumin concentration at critical phase ≤3.49 mg/dL had a score of 1 (OR, 4.48; 95 % CI, 1.87–10.77), lowest platelet count ≤49,500/μL had a score of 1 (OR, 3.62; 95 % CI, 1.55–8.49), and elevated ratio of AST ≥2.51 had a score of 1 (OR 2.67; 95 % CI, 1.19–5.97). At a cut off of ≥ 2, the Dengue Score predicted pleural effusion and/or ascites diagnosis with positive predictive value of 79.21 % and negative predictive value of 74.63 %. This prediction model is suitable for calibration and good discrimination. Conclusions We have developed a Dengue Score that could be used to identify pleural effusion and/or ascites and might be useful to stratify dengue-infected patients at risk for developing severe dengue.
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Affiliation(s)
- Suhendro Suwarto
- Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Leonard Nainggolan
- Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Robert Sinto
- Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Bonita Effendi
- Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Jakarta, Indonesia
| | - Eppy Ibrahim
- Department of Internal Medicine, Persahabatan Hospital, Jakarta, Indonesia
| | - Maulana Suryamin
- Department of Internal Medicine, Persahabatan Hospital, Jakarta, Indonesia
| | - R Tedjo Sasmono
- Eijkman Institute of Molecular Biology, Jl. Diponegoro 69, Jakarta, 10430, Indonesia.
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Levi JE. Dengue Virus and Blood Transfusion. J Infect Dis 2015; 213:689-90. [PMID: 26908779 DOI: 10.1093/infdis/jiv322] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 06/02/2015] [Indexed: 02/06/2023] Open
Affiliation(s)
- José Eduardo Levi
- Fundação Pró-Sangue/Hemocentro de São Paulo Hospital Israelita Albert Einstein Virology Laboratory, Instituto de Medicina Tropical da Universidade de São Paulo, Brazil
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19
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Affiliation(s)
- Milton Artur Ruiz
- Revista Brasileira de Hematologia e Hemoterapia, São José do Rio Preto, SP, Brazil, Editor-in-chief of Revista Brasileira de Hematologia e Hemoterapia (RBHH), São José do Rio Preto, SP, Brazil
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Lemes RPG. Comments on the clinical and laboratory characteristics of patients with dengue hemorrhagic fever manifestations and their transfusion profile**See paper by Fujimoto DE et al. on pages 115-20. Rev Bras Hematol Hemoter 2014; 36:100-1. [PMID: 24790531 PMCID: PMC4005504 DOI: 10.5581/1516-8484.20140022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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