PREDICTORS OF HOSPITAL STAY AND PROGNOSTIC FACTORS FOR DENGUE INFECTION IN HOLY FAMILY HOSPITAL, RAWALPINDI

Abstract

Background: The spread of dengue virus infection (DVI) is due to the increase in trade and tourism, which has inadvertently spread the virus from endemic regions to other parts of the world.  Recent epidemics in Pakistan have shown that the virus can cause significant health problems but there is a scarcity of data on the factors associated with increased hospital stay and mortality in DVI.

Objective: To identify and develop predictive models for the length of hospital stay and the risk of complications in patients with dengue infection.

Methods: The Department of Infectious Diseases, Holy Family Hospital, Rawalpindi, Pakistan, conducted this retrospective cohort study. The study spanned three months, and it comprised a sample size of 122 patients. Inclusion criteria involved patients admitted to the hospital with diagnoses of dengue infection, dengue hemorrhagic fever, or dengue shock syndrome, with their diagnoses confirmed through serology. Patients below 12 years of age and those with incomplete demographic information were excluded from the study.The association between outcomes, such as length of hospital stay (LOS), and other variables, was examined using chi-squared tests for categorical variables and Student's t-test for continuous variables. Binary logistic regression was employed to estimate odds ratios and their corresponding 95% confidence intervals concerning hospital stay duration (≤3 days versus >3 days).

Results: The study included 122 DVI patients, with a mean age of 42.06 years. The most common age group affected was 50-65 years old. Twenty-four patients had diabetes and 15 had hypertension. Eighty-six patients had DF, 28 had DHF, and 8 had DSS. Eleven patients developed respiratory failure and 18 had acute renal injury. The mortality rate was 4.1%. The mean LOS was 4.65 days. The study found that older age, co-morbid conditions, severity of infection, and end organ injury were all predictors for longer length of stay (LOS) in patients with DVI. Patients with DSS had the longest LOS, followed by patients with DHF and then patients with DF. Patients with higher levels of ALT or lower levels of platelets were also more likely to have a longer LOS. End organ injury, such as acute kidney injury, central nervous system injury, or respiratory injury, also significantly affected LOS.

Conclusion: The predictors of hospital stay and prognostic factors for dengue infection are a complex and evolving field of research. However, some of the most important factors that have been identified include age, severity of infection, co-morbid conditions and derangement in laboratory parameters.