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Abstract PD-011: RISK FACTORS FOR SEVERE DENGUE RETROSPECTIVE OBSERVATIONAL STUDY FROM A PICU IN SOUTHERN INDIA

Kedia, N.1; Mahadevan, S.1; Kumar, R.R.1

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 31
doi: 10.1097/01.pcc.0000537413.46591.8e
Poster Discussion Abstracts
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1Jawaharlal Institute of Postgraduate Medical Education and Research, Pediatrics, Pondicherry, India

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Aims & Objectives:

To describe clinical pattern of dengue fever (DF) and find out risk factors for severe dengue.

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Methods

A retrospective study covering calendar year 2017 was done in a tertiary care centre in south India. Case records of children (1 month-13 years) admitted to pediatric emergency with suspected DF were screened and data analyzed.

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Results

In 2017, 160 cases were screened of which 121(75.6%) were dengue proven (revised WHO case definition) and 22(13.8%) had probable dengue.

Cases were classified as DF (9.1%), dengue fever with warning signs (66.4%) and severe dengue (24.5%). Median age was 8 years (IQR 4.8–10 years) and 54.5% were males. Fever (100%), vomiting (76.2%) and pain abdomen (54.3%) were the most common presenting symptoms. Hepatomegaly (64.3%) and thrombocytopenia (86.5%) were the commonest sign and investigation findings. There were 2 deaths (0.01%) and shock (23.8%) and massive pleural effusion (14.7%) were most frequent complications (Figure).

Demographic parameters, symptoms, signs and investigations were studied as possible risk factors for severity. Female sex was associated with severe dengue (OR=1.6; 95% C.I. [0.74–3.45]). Among symptoms, bleeding tendency had significant association with severe dengue (OR=5.7; 95% C.I. [2.16–15.23]). Hepatomegaly (OR=3.5; 95% C.I. [1.32–9.0]) and severe thrombocytopenia (OR=3.63; 95% C.I. [1.5–8.8]) had significant association with severe dengue among signs and investigations (Table).

Table

Table

Figure

Figure

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Conclusions

Studies on pattern of DF from different regions should help in mapping global trends. The key to management in severe dengue is meticulous monitoring and supportive care. Identification of risk factors could streamline specific protocols for actionable outcomes in Pediatric Intensive Care Units.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies