An observational study of factors associated with dengue outcomes in intensive care unit / See Chang Seng
In Malaysia, dengue fever is one of the major public health problem which has had significant impact on socio-economic and health resources especially when involving intensive care unit (ICU) stay. This study aimed to determine the factors associated with outcomes in those dengue patients who adm...
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| Format: | Thesis |
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2019
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| Online Access: | http://studentsrepo.um.edu.my/11543/ http://studentsrepo.um.edu.my/11543/4/chang_seng.pdf |
| _version_ | 1848774412822642688 |
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| author | See, Chang Seng |
| author_facet | See, Chang Seng |
| author_sort | See, Chang Seng |
| building | UM Research Repository |
| collection | Online Access |
| description | In Malaysia, dengue fever is one of the major public health problem which has had
significant impact on socio-economic and health resources especially when involving
intensive care unit (ICU) stay. This study aimed to determine the factors associated with
outcomes in those dengue patients who admitted to ICU. This was a retrospective
observational study of patients in a tertiary level state hospital in Malaysia, between Jan
1 and Dec 31 2017. Patients with confirmed dengue diagnosis were stratified into 2
groups based on ICU stay (≤ 3 days or > 3 days) and mortality (fatal and non-fatal cases).
Socio-demographic, clinico-laboratory data and therapeutic parameters between these
groups were compared by using appropriate statistical analysis method. Total 140 patients
were included in this study with mean length of ICU stay 3.79+2.47 days. Mortality rate
among these patients was 7.8% and prolonged stay was seen in 36.4% studied patients.
Factors including age > 50 years old, pre-existing diabetes mellitus and hypertension,
higher number of co-morbidities, prolonged prothrombin time and activated partial
thromboplastin time, thrombocytopenia, hypoalbuminemia, increased creatinine, alanine
aminotransferase and aspartate aminotransferase level, and dialysis support were
common seen in non-survivors. However, multiple logistic regression analysis showed
only number of co-morbidities (OR 2.6, 95% CI 1.26 to 5.38, p-value 0.009) and aspartate
aminotransferase (AST) level (OR 1.0, 95% CI 1.0-1.01, p-value 0.001) were found
independently significant factors associated with dengue mortality. Meanwhile, patients
having severe dengue, pre-existing blood disorder, increased number of co-morbidities,
renal impairment, mild thrombocytopenia, required intubation or inotropic support were
significantly associated with prolonged ICU stay. However, only female gender (OR
0.36, 95% CI 0.14 to 0.90, p-value 0.029) and elevation of activated partial thrombin time
iv
2 times above normal value (OR 0.11, 95% CI 0.02 to 0.66, p-value 0.015) were found
to be independently significant related to ICU stay duration. In conclusion, early
recognition of risk factors associated with prolonged ICU stay and mortality among
dengue fever patients can help in early decision making for ICU admission. Hence early
aggressive care and organ support from ICU on higher risk patients can help in decreasing
dengue morbidity and mortality. |
| first_indexed | 2025-11-14T13:57:54Z |
| format | Thesis |
| id | um-11543 |
| institution | University Malaya |
| institution_category | Local University |
| last_indexed | 2025-11-14T13:57:54Z |
| publishDate | 2019 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | um-115432020-08-24T17:33:33Z An observational study of factors associated with dengue outcomes in intensive care unit / See Chang Seng See, Chang Seng R Medicine (General) RA0421 Public health. Hygiene. Preventive Medicine In Malaysia, dengue fever is one of the major public health problem which has had significant impact on socio-economic and health resources especially when involving intensive care unit (ICU) stay. This study aimed to determine the factors associated with outcomes in those dengue patients who admitted to ICU. This was a retrospective observational study of patients in a tertiary level state hospital in Malaysia, between Jan 1 and Dec 31 2017. Patients with confirmed dengue diagnosis were stratified into 2 groups based on ICU stay (≤ 3 days or > 3 days) and mortality (fatal and non-fatal cases). Socio-demographic, clinico-laboratory data and therapeutic parameters between these groups were compared by using appropriate statistical analysis method. Total 140 patients were included in this study with mean length of ICU stay 3.79+2.47 days. Mortality rate among these patients was 7.8% and prolonged stay was seen in 36.4% studied patients. Factors including age > 50 years old, pre-existing diabetes mellitus and hypertension, higher number of co-morbidities, prolonged prothrombin time and activated partial thromboplastin time, thrombocytopenia, hypoalbuminemia, increased creatinine, alanine aminotransferase and aspartate aminotransferase level, and dialysis support were common seen in non-survivors. However, multiple logistic regression analysis showed only number of co-morbidities (OR 2.6, 95% CI 1.26 to 5.38, p-value 0.009) and aspartate aminotransferase (AST) level (OR 1.0, 95% CI 1.0-1.01, p-value 0.001) were found independently significant factors associated with dengue mortality. Meanwhile, patients having severe dengue, pre-existing blood disorder, increased number of co-morbidities, renal impairment, mild thrombocytopenia, required intubation or inotropic support were significantly associated with prolonged ICU stay. However, only female gender (OR 0.36, 95% CI 0.14 to 0.90, p-value 0.029) and elevation of activated partial thrombin time iv 2 times above normal value (OR 0.11, 95% CI 0.02 to 0.66, p-value 0.015) were found to be independently significant related to ICU stay duration. In conclusion, early recognition of risk factors associated with prolonged ICU stay and mortality among dengue fever patients can help in early decision making for ICU admission. Hence early aggressive care and organ support from ICU on higher risk patients can help in decreasing dengue morbidity and mortality. 2019 Thesis NonPeerReviewed application/pdf http://studentsrepo.um.edu.my/11543/4/chang_seng.pdf See, Chang Seng (2019) An observational study of factors associated with dengue outcomes in intensive care unit / See Chang Seng. Masters thesis, University of Malaya. http://studentsrepo.um.edu.my/11543/ |
| spellingShingle | R Medicine (General) RA0421 Public health. Hygiene. Preventive Medicine See, Chang Seng An observational study of factors associated with dengue outcomes in intensive care unit / See Chang Seng |
| title | An observational study of factors associated with dengue outcomes in intensive care unit / See Chang Seng |
| title_full | An observational study of factors associated with dengue outcomes in intensive care unit / See Chang Seng |
| title_fullStr | An observational study of factors associated with dengue outcomes in intensive care unit / See Chang Seng |
| title_full_unstemmed | An observational study of factors associated with dengue outcomes in intensive care unit / See Chang Seng |
| title_short | An observational study of factors associated with dengue outcomes in intensive care unit / See Chang Seng |
| title_sort | observational study of factors associated with dengue outcomes in intensive care unit / see chang seng |
| topic | R Medicine (General) RA0421 Public health. Hygiene. Preventive Medicine |
| url | http://studentsrepo.um.edu.my/11543/ http://studentsrepo.um.edu.my/11543/4/chang_seng.pdf |