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RISK FACTORS OF MORTALTIY AMONG PATIENTS SUFFERING FROM DENGUE INFECTION

Dr Muhammad Tauqeer Nazeer, Dr Abdul Mannan, Dr Muhammad Usman Zafar

Objective: There is an increase in the dengue infection in our country Pakistan from last few years with adverse outcomes. Data about the risk factors of mortality because of this viral infection is not sufficient. We conducted this research study to determine the main factors responsible of death among patients having dengue infection in Mayo Hospital Lahore to identify the complication in initial stage and to improve the treatment in coming future. Methodology: The design of this study was an observational study and the study was conducted at Mayo Hospital, Lahore from August 2018 to January 2020. All the patients who were positive for dengue IgM in presence of febrile illness completing the criteria of WHO for Dengue Fever, Dengue Shock Syndrome or Dengue Hemorrhagic Fever and died in the same setting were only the participants of this research work. Information about demography, parameters of clinical and laboratory findings in addition with the detail of treatment were under discussion and analysis. We anonymized all examined records. Results: The average age 36 year with a range of 13 to 80 years among 95 mortalities because of dengue. There were total 63.1% (n: 60) males. We found co-morbidities present in 77.9% (n: 74) patients with Hypertension in 22.1% (n: 21), Diabetes Mellitus in 11.58% (n: 11), diseases of liver in 9.47% (n: 9) and Ischemic Heart Disease in 8.4% (n: 8) patients. Patients appeared at 2nd day of febrile illness and mortality occurred at median of four days with a range of 30 minutes to 23 days. The stay in hospital was lower than 7 days for 83.2% (n: 79) patients and 16.8% (n: 16) remain admitted for greater than 7 days. There was requirement of critical care in 71% (n: 67) patients. There was occurrence of severe hepatitis in 43.1% (n: 41) patients, renal impairment in 33.7% (n: 32) and intra-vascular coagulation occurred in 16.8% (n: 16) patients. Deaths were the outcome of prolonged shock in 51.5% (n: 49), fluid overload in 48.4% (n: 46) and bleeding in 19% (n: 18) causing the failure of organ. Conclusion: High leakage of plasma, failure of organs and fluid overloading were the main cause of increased mortality in the patients suffering from dengue infection. Co-morbidities, particularly Diabetes Mellitus, are the adverse prognostic factors for the prediction of the mortality due to dengue infection. KEYWORDS: Dengue Fever, Organ Failure, Co-Morbidities, Impairment, Mortality, Ischemic Heart Disease, Syndrome, Overload.