title: Diabetes, cardiac disorders and asthma as risk factors for severe organ involvement among adult dengue patients: A matched case-control study.
abstract: Progression to severe organ involvement due to dengue infection has been associated with severe dengue disease, intensive care treatment, and mortality. However, there is a lack of understanding of the impact of pre-existing comorbidities and other risk factors of severe organ involvement among dengue adults. The aim of this retrospective case-control study is to characterize and identify risk factors that predispose dengue adults at risk of progression with severe organ involvement. This study involved 174 dengue patients who had progressed with severe organ involvement and 865 dengue patients without severe organ involvement, matched by the year of presentation of the cases, who were admitted to Tan Tock Seng Hospital between year 2005 and 2008. Age group of 60 years or older, diabetes, cardiac disorders, asthma, and having two or more pre-existing comorbidities were independent risk factors of severe organ involvement. Abdominal pain, clinical fluid accumulation, and hematocrit rise and rapid platelet count drop at presentation were significantly associated with severe organ involvement. These risk factors, when validated in a larger study, will be useful for triage by clinicians for prompt monitoring and clinical management at first presentation, to minimize the risk of severe organ involvement and hence, disease severity.
authors.affiliation: Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore.|Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: Junxiong
authors.initials: J
authors.lastname: Pang
authors.affiliation: Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore.
authors.forename: Jung Pu
authors.initials: JP
authors.lastname: Hsu
authors.affiliation: Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore.|Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
authors.forename: Tsin Wen
authors.initials: TW
authors.lastname: Yeo
authors.affiliation: Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore.|Saw Swee Hock School of Public Health, National University of Singapore, Singapore.|Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Yee Sin
authors.initials: YS
authors.lastname: Leo
authors.affiliation: Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore.|Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.|Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: David C
authors.initials: DC
authors.lastname: Lye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D003715:Dengue / Q000150:complications / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged