Clinical, laboratory, and demographic determinants of hospitalization due to dengue in 7613 patients: A retrospective study based on hierarchical models

Author(s)

da Silva, Natal Santos ^{[1, 2, 3]} ; Undurraga, Eduardo A. ^{[4, 5]} ; da Silva Ferreira, Elis Regina ^[2] ; Estofolete, Cassia Fernanda ^[1] ; Nogueira, Mauricio Lacerda ^[1]

Affiliation

^[1] Fac Med Sao Jose do Rio Preto, Lab Pesquisa Virol, Brigadeiro Feria Lima Ave 5416, BR-15090000 Sao Jose Do Rio Preto, SP - Brazil

^[2] Uniao Fac Grandes Lagos, Fac Med, Rua Dr Eduardo Nielsem 960, BR-15030070 Sao Jose Do Rio Preto, SP - Brazil

^[3] Uniao Fac Grandes Lagos, Fac Med, Lab Modelagens Matemat & Estat Med, Rua Dr Eduardo Nielsem 960, BR-15030070 Sao Jose Do Rio Preto, SP - Brazil

^[4] Pontificia Univ Catolica Chile, Escuela Gobierno, Santiago, Region Memopoli - Chile

^[5] Pontificia Univ Catolica Chile, Escuela Gobiemo, Vicuna Mackenna 4860, Macul 7820436, Region Metropol - Chile

• Document type: Journal article
• Source: Acta Tropica; v. 177, p. 25-31, JAN 2018.
• Web of Science Citations: 1

Abstract

In Brazil, the incidence of hospitalization due to dengue, as an indicator of severity, has drastically increased since 1998. The objective of our study was to identify risk factors associated with subsequent hospitalization related to dengue. We analyzed 7613 dengue confirmed via serology (ELISA), non-structural protein 1, or polymerase chain reaction amplification. We used a hierarchical framework to generate a multivariate logistic regression based on a variety of risk variables. This was followed by multiple statistical analyses to assess hierarchical model accuracy, variance, goodness of fit, and whether or not this model reliably represented the population. The final model, which included age, sex, ethnicity, previous dengue infection, hemorrhagic manifestations, plasma leakage, and organ failure, showed that all measured parameters, with the exception of previous dengue, were statistically significant. The presence of organ failure was associated with the highest risk of subsequent dengue hospitalization (OR = 575; CI = 3.53-9.37). Therefore, plasma leakage and organ failure were the main indicators of hospitalization due to dengue, although other variables of minor importance should also be considered to refer dengue patients to hospital treatment, which may lead to a reduction in avoidable deaths as well as costs related to dengue. (AU)

• FAPESP's process: 13/21719-3 - Epidemiological study of dengue (serotypes1-4) in a cohort of São José do Rio Preto, São Paulo, Brazil, during 2014-2018
• Grantee: Maurício Lacerda Nogueira
• Support Opportunities: Research Projects - Thematic Grants