Mortality Predictors in Patients with Severe Dengue in the State of Amazonas, Brazil
Mortality Predictors in Patients with Severe Dengue in the State of Amazonas, Brazil
Data
2016
Autores
Pinto, Rosemary Costa
Castro, Daniel Barros de
Albuquerque, Bernardino Cláudio de
Sampaio, Vanderson de Souza
Passos, Ricardo Augusto dos
Costa, Cristiano Fernandes da
Sadahiro, Megumi
Braga, José Ueleres
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS ONE
Resumo
Dengue is a major public health problem in tropical and subtropical areas worldwide. There
is a lack of information on the risk factors for death due to severe dengue fever in developing
countries, including Brazil where the state of Amazonas is located. This knowledge is impor-
tant for decision making and the implementation of effective measures for patient care. This
study aimed to identify factors associated with death among patients with severe dengue, in
Amazonas from 2001 to 2013. We conducted a retrospective cohort study based on sec-
ondary data from the epidemiological surveillance of dengue provided by the Fundação de
Vigilância em Saúde do Amazonas, FVS (Health Surveillance Foundation) of the Secretaria
de Saúde do Amazonas, SUSAM (Health Secretariat of the State of Amazonas). Data on
dengue cases were obtained from the SINAN (Notifiable Diseases Information System) and
SIM (Mortality Information System) databases. We selected cases of severe dengue with
laboratory confirmation, including dengue-related deaths of residents in the state of Amazo-
nas from January 1, 2001, to December 31, 2013. The explanatory variables analyzed were
sex, age, level of education, spontaneous hemorrhagic manifestations, plasma extravasa-
tion and platelet count. Patients who died due to severe dengue had more hematuria, gas-
trointestinal bleeding, and thrombocytopenia than the survivors. Considering the
simultaneous effects of demographic and clinical characteristics with a multiple logistic
regression model, it was observed that the factors associated with death were age >55
years (odds ratio [OR] 4.98), gastrointestinal bleeding (OR 10.26), hematuria (OR 5.07),
and thrombocytopenia (OR 2.55). Gastrointestinal bleeding was the clinical sign most
strongly associated with death, followed by hematuria and age >55 years. The study results
showed that the best predictor of death from severe dengue is based on the characteristic
of age >55 years, together with the clinical signs of gastrointestinal bleeding, hematuria,
and low platelet count.
Description
Palavras-chave
Adolescent, Adult, Brazil / epidemiology, Disease Outbreaks, Female, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Retrospective Studies, Risk Factors, Severe Dengue / epidemiology*, Severe Dengue / mortality*, Severity of Illness Index, Young Adult
Citação
Pinto RC, Castro DB, Albuquerque BC, Sampaio Vde S, Passos RA, Costa CF, Sadahiro M, Braga JU. Mortality Predictors in Patients with Severe Dengue in the State of Amazonas, Brazil. PLoS One. 2016 Aug 26;11(8):e0161884. doi: 10.1371/journal.pone.0161884.