Severe coma, renal failure predict mortality in elderly with dengue
Survival rate in geriatric patients with dengue fever is high, given the absence of any of the following predictors: severe coma, severe hepatitis, renal failure and being bedridden, a new retrospective case-control study has shown.
In contrast, those with at least two predictors have an almost 60 percent mortality rate.
Medical records of 627 elderly patients (mean age 74.09±6.28 years) who were admitted into a tertiary medical hospital during the 2015 dengue fever outbreak in Taiwan were accessed. Of these, 27 patients had died, resulting in a mortality rate of 4.3 percent.
In terms of comorbidity, patients who died had significantly higher percentages of pressure ulcer (p=0.015), anaemia (p=0.04), respiratory failure (p<0.001), diabetes mellitus (p=0.038) and coronary artery disease (p=0.04), among other conditions, than those without mortality.
In multivariate logistic regression analysis, severe coma (adjusted odds ratio [OR], 11.36; 95 percent CI, 1.89 to 68.19; p=0.08), being bedridden (adjusted OR, 10.46; 1.58 to 69.16; p=0.015), severe hepatitis (adjusted OR, 96.08; 14.11 to 654.39; p<0.001) and renal failure (adjusted OR, 6.03; 1.50 to 24.246; p=0.011) were the four significant predictors of mortality.
When combined, all four predictors yielded a sensitivity of 70.37 percent for patients with at least one predictor. The specificity, positive predictive value (PPV) and negative predictive value (NPV) were 88.17, 21.11 and 98.51 percent, respectively.
In comparison, sensitivity for those with at least two predictors was 33.33 percent. The corresponding specificity, PPV and NPV were 99.44, 57.14 and 98.51 percent.