title: Atypical presentations of dengue disease in the elderly visiting the ED.
abstract: OBJECTIVE
  The objective was to compare the clinical characteristics of elderly and young adult patients with dengue in the emergency department (ED).
  
  
  METHODS
  Demographic characteristics, clinical presentation, disease severity, laboratory characteristics, and outcomes were analyzed prospectively as a case-control study.
  
  
  RESULTS
  Of the 193 adults with serologically confirmed dengue disease in 2007, 31 (16.1%) were elderly patients (aged ≥65) and 162 were young adults (aged <65). More dengue hemorrhagic fever (12.9% vs 2.5%, P = .02), a longer ED stay (13.3 vs 8.6 hours, P = .004), a longer hospital stay (7.4 vs 3.4 days, P < .001), a higher Simplified Acute Physiology Score II in the ED (29.7 vs 17.4, P < .001), and a higher rate of at least 1 comorbidity (61.8 vs 22.8%, P < .001) were found in the elderly. However, the length of the intensive care unit stay (elderly 0.7 vs young adults 0.3 day, P = .47) and the 14-day mortality rate (0% vs 0.6%, P = 1.00) were similar. Of note, in terms of clinical presentations of dengue in the ED, there were more elderly patients with isolated fever (41.9% vs 17.9%, P = .003) and fewer with typical presentation (41.9% vs 75.9%, P = <.001) than there were young adults.
  
  
  CONCLUSIONS
  The present study found a higher number of atypical presentations, a longer hospitalization, and a higher degree of clinical illness in elderly patients with dengue.
authors: Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 704, Taiwan.
authors: Ching-Chi
authors: CC
authors: Lee
authors: Hsiang-Chin
authors: HC
authors: Hsu
authors: Chia-Ming
authors: CM
authors: Chang
authors: Ming-Yuan
authors: MY
authors: Hong
authors: Wen-Chien
authors: WC
authors: Ko
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003715:Dengue / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D013624:Taiwan
chemical_list: D015415:Biomarkers