Predictors of Mortality in Patients With Dengue Fever: Insights From a Comparative Analysis

Afsheen Mahmood; Anwar Ul Haq; Said Amin; Fawad Rahim; Mohammad Noor; Huma Gul; Sheraz Zafar; Sobia Ahmed Qureshi; Khaula Batul; Mohsina Haq

doi:10.7759/cureus.36040

Predictors of Mortality in Patients With Dengue Fever: Insights From a Comparative Analysis

Cureus. 2023 Mar 12;15(3):e36040. doi: 10.7759/cureus.36040. eCollection 2023 Mar.

Authors

Afsheen Mahmood¹, Anwar Ul Haq^{2

1}, Said Amin^{2

1}, Fawad Rahim^{2

1}, Mohammad Noor^{2

1}, Huma Gul³, Sheraz Zafar¹, Sobia Ahmed Qureshi¹, Khaula Batul¹, Mohsina Haq⁴

Affiliations

¹ Internal Medicine, Hayatabad Medical Complex, Peshawar, PAK.
² Internal Medicine, Khyber Girls Medical College, Peshawar, PAK.
³ Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
⁴ Microbiology, Peshawar Medical College, Peshawar, PAK.

Abstract

Objective To determine the clinical and biochemical predictors of mortality in patients with dengue fever. Methods This was an analytical, cross-sectional study conducted at Hayatabad Medical Complex, Peshawar, Pakistan. The study participants were patients admitted to the hospital for the management of dengue fever. Clinical parameters (age, gender, duration of hospital stay, and the presence of complications) and biochemical parameters [white blood cells count (WBC), platelet count, serum c-reactive protein (CRP) level, serum alanine aminotransferase (ALT) level, and serum creatinine] were recorded. These parameters were compared between the survivors and non-survivors of dengue fever. Results Out of 115 patients, the majority (n=82, 71.3%) were up to 45 years and the mean age was 38.40 ± 18.1 years. Most of the patients (n=105, 91.3%) survived. On univariate logistic regression analysis, age more than 45 years [odds ratio (OR) 0.141, 95% confidence interval (CI) 0.034 - 0.585, p = 0.007), leukocytosis (> 11,000/mcL) (OR 0.187, 95% CI 0.049 - 0.719, p = 0.015), and acute kidney injury (creatinine > 1.5 mg/dL) (OR 0.124, 95% CI 0.029 - 0.531, p = 0.005)] at the time of admission reduced the likelihood to survive. Leukocytosis and acute kidney injury remained significant independent predictors of mortality on multivariate logistic regression analysis. [(OR 0.201, 95% CI 0.042 - 0.960, p = 0.044) and (OR 0.148, 95% CI 0.026 - 0.857, p = 0.033) for survival, respectively]. Gender, duration of inpatient stay, thrombocytopenia (platelets < 30,000/mcL), and acute liver injury (ALT > 200 IU/L) were not associated with mortality from dengue fever. Conclusion Age over 45 years, leukocytosis, and acute kidney injury at presentation increased the likelihood of mortality from dengue fever in this study. Gender, duration of hospital stay, thrombocytopenia, and acute liver injury did not affect the odds of mortality.

Keywords: acute kidney injury; alanine aminotransferase; c reactive protein; dengue fever; determinant; fatal outcome; leukocytosis; mortality; risk factor; thrombocytopenia.