Differences in Mortality and Clinical Manifestations of Dengue Hemorrhagic Fever in Taiwan in Different Years: A Comparison for Cases in 2014 and 2015 Epidemics

被引：25

作者：

Chang, Ko ^{[1
,2
,3
]}

Huang, Chung-Hao ^{[1
]}

Lee, Ing-Kit ^{[4
]}

Lu, Po-Liang ^{[1
,2
]}

Lin, Chun-Yu ^{[1
,2
]}

Chen, Tun-Chieh ^{[1
,2
,5
]}

Lai, Ping-Chang ^{[6
]}

Hsieh, Hsiao-Cheng ^{[7
]}

Yu, Hsin-Liang ^{[8
]}

Hung, Chih-Hsing ^{[9
]}

Wu, Meng-Chieh ^{[1
,3
]}

Chin, Yi-Ying ^{[10
]}

Huang, Chun-Chi ^{[11
]}

Wu, Deng-Chyang ^{[1
,2
,10
]}

Chen, Yen-Hsu ^{[12
,13
]}

机构：

[1] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Div Infect Dis, Dept Internal Med, Kaohsiung, Taiwan

[2] Kaohsiung Med Univ, Coll Med, Fac Med, Dept Internal Med, Kaohsiung, Taiwan

[3] Kaohsiung Med Univ, Dept Internal Med, Kaohsiung, Taiwan

[4] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Dept Internal Med, Kaohsiung, Taiwan

[5] Kaohsiung Med Univ, Kaohsiung Municipal Ta Tung Hosp, Dept Internal Med, Kaohsiung, Taiwan

[6] St Joseph Hosp, Dept Internal Med, Kaohsiung, Taiwan

[7] Yuans Gen Hosp, Dept Internal Med, Kaohsiung, Taiwan

[8] Kaohsiung Municipal Minsheng Hosp, Dept Internal Med, Kaohsiung, Taiwan

[9] Kaohsiung Med Univ, Dept Pediat, Kaohsiung, Taiwan

[10] Kaohsiung Med Univ, Dept Dermatol, Kaohsiung, Taiwan

[11] Kaohsiung Med Univ, Kaohsiung Municipal Hsiao Kang Hosp, Dept Lab Med, Kaohsiung, Taiwan

[12] Kaohsiung Med Univ, Sch Med, Grad Inst Med, Sepsis Res Inst,Coll Med, Kaohsiung, Taiwan

[13] Natl Chiao Tung Univ, Coll Biol Sci & Technol, Dept Biol Sci & Technol, Hsinchu, Taiwan

来源：

AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE | 2017年 / 97卷 / 02期

关键词：

INTENSIVE-CARE-UNIT; VIRAL-INFECTION; VIRUS-INFECTION; RISK-FACTORS; CHILDREN; CLASSIFICATION; DEFINITIONS; OUTBREAK;

D O I：

10.4269/ajtmh.16-1018

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

People in southern Taiwan experienced two major dengue outbreaks in 2014 and 2015. The mortality and clinical features were very different between these 2 years. Dengue virus serotype 1 (DENV-1) caused epidemic outbreak in 2014 and DENV-2 was predominant in 2015. The characteristics of dengue hemorrhagic fever (DHF) cases in the 2 years was analyzed. We conducted a retrospective chart review to analyze the clinical and laboratory features of 206 adult patients with DHF in southern Taiwan in 2014 and 2015. The mortality rate of DHF cases in 2015 was higher than that of cases in 2014 (38.7% versus 12.4%, P < 0.0001). Compared with cases in 2014, DHF cases in 2015 had more complications, such as gastrointestinal bleeding (78.5% versus 61.9%, P = 0.01), severe hepatitis (30.1% versus 8%, P < 0.0001), and myocarditis (14% versus 0.9%, P < 0.0001). Among the mortality cases, diabetes, chronic renal failure, proton-pump inhibitors using, platelet transfusion, and Charlson comorbidity index score (Charlson score) were also higher in 2015. Multivariate analysis for the mortality cases revealed that the risk factors were Charlson score (3) 5 (P = 0.02, odds ratio [OR] = 4.07, 95% confidence interval [CI] = 1.244-13.307), severe hepatitis (P < 0.0001, OR = 11.97, 95% CI = 3.831-37.396), and acute renal failure (P < 0.0001, OR = 98.76, 95% CI = 10.847-899.22). DHF cases in 2015 had higher mortality and more complications, such as gastrointestinal bleeding, severe hepatitis, and myocarditis, than in 2014 in southern Taiwan. In the 2-year DHF case series, Charlson score >= 5, severe hepatitis, and acute renal failure were independent significant variables for mortality.

引用

页码：361 / 368

页数：8