RESEARCH TITLE: "STUDY OF FACTORS INFLUENCING MORBIDITY AND ROLE OF DEXAMETHASONE IN LABORATORY-CONFIRMED DENGUE PATIENTS: A SINGLE CENTRE RETROSPECTIVE ANALYSIS"
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Abstract
Background: Dengue is a significant global health concern, particularly in tropical and subtropical regions. Understanding the factors influencing morbidity and the potential benefits of treatments like Dexamethasone is crucial for improving patient outcomes. This study focuses on the clinical and laboratory parameters that predict ICU admission and evaluates the role of Dexamethasone in managing severe Dengue cases.
Objectives: The study aims to determine the incidence of Dengue patients requiring critical care and extended hospital stays, identify clinical and laboratory risk factors associated with ICU admission, and investigate the effect of steroids, specifically Dexamethasone, in reducing hospital stay and complications in laboratory-confirmed Dengue patients.
Methodology: This observational, retrospective study used medical records of laboratory-confirmed Dengue patients at Vedant Hospital, Pimpri, Pune. Data collected included demographic information, clinical presentation, laboratory parameters, severity indicators, steroid usage, total length of stay, and ICU duration.
Results: Among 200 patients, 58% were male and 42% female, with a majority (94%) residing in urban areas. ICU admissions showed no significant associations with gender, address, or age. Decreased appetite (69% ICU vs. 39.4% non-ICU, p<0.0001) and chest pain (3.4% ICU vs. 0% non-ICU, p=0.026) were more common in ICU patients, while myalgia was more frequent in non-ICU patients (31% vs. 6.9%, p<0.0001).
ICU patients had lower platelet counts (61,310 ± 72,229 vs. 127,355 ± 87,736, p<0.0001) and higher bilirubin (0.88 ± 0.67 vs. 0.73 ± 0.30, p=0.036) and ALT levels (130.21 ± 129.03 vs. 92.98 ± 90.93, p=0.022). Neutrophil counts were higher in ICU patients (63.34 ± 15.71 vs. 57.13 ± 20.57, p=0.04). Hemoglobin levels were higher in ICU patients (14.21 ± 1.87 vs. 13.54 ± 1.70, p=0.015). Oxygen supplementation was required by 6.9% of ICU patients (p<0.0001).
Steroid use was more prevalent in ICU patients (93.1% vs. 84.5%). SDP transfusions were more common in ICU patients (72.4% vs. 1.4%, p<0.0001).
Patients treated with Dexamethasone (N=174) had longer illness durations (5.29 ± 1.41 days vs. 4.54 ± 1.10 days, p=0.01) and lower platelet counts (98.7 ± 86.4 x 10^3 vs. 171.8 ± 77.5 x 10^3, p<0.001), indicating Dexamethasone use in severe cases.
Conclusion: Significant clinical and laboratory differences exist between ICU and non-ICU Dengue patients. Dexamethasone was used in more severe cases, suggesting its potential role in managing severe Dengue symptoms and complications. Further research is needed to determine the benefits of steroid use in Dengue treatment.
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Dr. Abhishek Karmalkar
Consultant Vedant Multispecialty Hospital, Pimpri, Pune.
Deepak Bagde
Deepak Bagde, Head Operations, Clinithink Services, Pune.