title: Factors of severity at admission during an epidemic of dengue 1 in New Caledonia (South Pacific) in 2003.
abstract: We report a retrospective study of an epidemic of dengue in New-Caledonia (South Pacific) in 2003 among adult inpatients. The aim was to establish clinical and biological criteria for the severity of the infection at the time of admission. During 7 months, all inpatients older than 15 y having a laboratory-confirmed diagnosis of dengue fever (IgM or PCR) were included (n=170). Two groups were defined: severe cases (death and/or transfer to intensive care unit, n=24) and benign cases (n=146). Data were analysed using Epi-Info software. Univariate analysis showed that shock, haemorrhage and neurological complications were significantly more frequent in serious cases, respectively 37.5% vs 0.7%, 62.5% vs 32.2%, 25% vs 9.6% (p<0.05). Relevant biological criteria were: creatinine > 140 micromol/l (OR 12 (95% CI 3.93-37.44)), free bilirubin > 18 micromol/l (OR 12.69 ( 95% CI 2.88-59.5)), amylase > 220 UI/l (OR 27.34 (95% CI 4.57-210)) and platelets < 45,000/mm3 (OR 4.35 (95% CI 1.43-14.2)) with p<0.005 (VPP = 100% for association of 3 criteria). We suggest this combination of 4 biological criteria inclines to severity.
authors.affiliation: mariebouldouyre@netcourrier.com
authors.forename: M A
authors.initials: MA
authors.lastname: Bouldouyre
authors.forename: F
authors.initials: F
authors.lastname: Baumann
authors.forename: A
authors.initials: A
authors.lastname: Berlioz-Arthaud
authors.forename: E
authors.initials: E
authors.lastname: Chungue
authors.forename: F
authors.initials: F
authors.lastname: Lacassin
mesh_terms: D000681:Amylases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D001792:Blood Platelets / Q000166:cytology; D003404:Creatinine / Q000097:blood; D003422:Critical Care; D003715:Dengue / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D003716:Dengue Virus; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009510:New Caledonia / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D014218:Triage
chemical_list: D007075:Immunoglobulin M; D003404:Creatinine; D000681:Amylases; D001663:Bilirubin