PREDICTORS OF SEVERITY OF DENGUE IN PATIENTS ADMITTED TO ICU: A CROSS SECTIONAL STUDY

Abstract

Background & Objectives: Dengue mostly causes a mild self-limiting disease but a small proportion may progress to develop severe dengue clinical manifestations, which require interventions in intensive care. The objective of the study was to describe the clinical profile, course, and outcome of dengue-infected patients admitted to intensive care units (ICU) and to evaluate factors associated with morbidity and mortality. Methods: This is an observational, descriptive study. Patients above the age of 18 admitted directly or transferred to ICU from another ward with serological evidence of dengue (positive NS1 antigen and/or IgM antibodies to dengue) were included in the study. The severity of the illness was assessed using APACHE and SOFA Scores. The primary outcome was mortality, while the secondary outcome was the length of stay in the ICU. Results: A total of 80 patients were studied and the mean age of the study subjects was 36.53 (± 15.28) years. The median duration of ICU stay was 2 days with an IQR of (1-3) days. The mean APACHE was 21.53 (±10.91) while the mean SOFA score was 12.05 (± 4.70). The area under the curve for the WHO classification of severe dengue was 79%, with a positive predictive value of 58.70. The area under the curve for lactate was 89% with a positive predictive value of 90.48. Interpretation & Conclusion: Lactate alone is a good predictor of mortality in severe dengue. APACHE and SOFA scores are good predictors of mortality.