title: Clinical Profiles and Factors Associated with Death in Adults with Dengue Admitted to Intensive Care Units, Minas Gerais, Brazil.
abstract: The purpose of our study was to describe the clinical profile of dengue-infected patients admitted to Brazilian intensive care units (ICU) and evaluate factors associated with death. A longitudinal, multicenter case series study was conducted with laboratory-confirmed dengue patients admitted to nine Brazilian ICUs situated in Minas Gerais state, southeastern Brazil from January 1, 2008, to December 31, 2013. Demographic, clinical and laboratory data; disease severity scores; and mortality were evaluated. A total of 97 patients were studied. The in-ICU and in-hospital mortality rates were 18.6% and 19.6%, respectively. Patients classified as having severe dengue according to current World Health Organization classifications showed an increased risk of death in a univariate analysis. Nonsurvivors were older, exhibited lower serum albumin concentrations and higher total leukocyte counts and serum creatinine levels. Other risk factors (vomiting, lethargy/restlessness, dyspnea/respiratory distress) were also associated with death in a univariate analysis. Multivariate analysis indicated that in-hospital mortality was significantly associated with Acute Physiology and Chronic Health Evaluation II and the Sequential Organ Failure Assessment score. The ICU and in-hospital mortality observed in this study were higher than values reported in similar studies. An increased frequency of ICU admission due to severe organ dysfunction, higher severity indices and scarcity of ICU beds may partially explain the higher mortality.
authors.affiliation: Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Hospital João XXIII, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Frederico Figueiredo
authors.initials: FF
authors.lastname: Amâncio
authors.affiliation: Hospital Cesar Leite, Manhuaçu, Minas Gerais, Brazil.
authors.forename: Tiago Pires
authors.initials: TP
authors.lastname: Heringer
authors.affiliation: Faculdade de Medicina, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
authors.forename: Cristina da Cunha Hueb Barata
authors.initials: Cda C
authors.lastname: de Oliveira
authors.affiliation: Hospital Dr. Moises Magalhaes Freire, Pirapora, Minas Gerais, Brazil.
authors.forename: Liliane Boaventura
authors.initials: LB
authors.lastname: Fassy
authors.affiliation: Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Hospital Odilon Behrens, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Frederico Bruzzi
authors.initials: FB
authors.lastname: de Carvalho
authors.affiliation: Hospital João XXIII, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Daniela Pagliari
authors.initials: DP
authors.lastname: Oliveira
authors.affiliation: Hospital Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Claudio Dornas
authors.initials: CD
authors.lastname: de Oliveira
authors.affiliation: Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Hospital Risoleta Tolentino Neves, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Fernando Otoni
authors.initials: FO
authors.lastname: Botoni
authors.affiliation: Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Fernanda do Carmo
authors.initials: Fdo C
authors.lastname: Magalhães
authors.affiliation: Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: José Roberto
authors.initials: JR
authors.lastname: Lambertucci
authors.affiliation: Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Mariângela
authors.initials: M
authors.lastname: Carneiro
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D003715:Dengue / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult