Markers of prolonged hospitalisation in severe dengue.

Autor: Recker M; Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany.; Centre for Ecology and Conservation, University of Exeter, Penryn Campus, Penryn, United Kingdom., Fleischmann WA; Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany., Nghia TH; 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam., Truong NV; 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam., Nam LV; 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam., Duc Anh D; Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany.; Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam., Song LH; Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam.; 108 Military Central Hospital, Hanoi, Vietnam., The NT; Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam.; 108 Military Central Hospital, Hanoi, Vietnam., Anh CX; 108 Military Central Hospital, Hanoi, Vietnam., Hoang NV; 108 Military Central Hospital, Hanoi, Vietnam., My Truong N; Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam.; 108 Military Central Hospital, Hanoi, Vietnam., Toan NL; Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam.; Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam., Kremsner PG; Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany.; Centre de Recherches Médicales de Lambaréné (CERMEL), Gabon., Velavan TP; Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany.; Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam.; Faculty of Medicine, Duy Tan University, Da Nang, Vietnam.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2024 Jan 30; Vol. 18 (1), pp. e0011922. Date of Electronic Publication: 2024 Jan 30 (Print Publication: 2024).
DOI: 10.1371/journal.pntd.0011922
Abstrakt: Background: Dengue is one of the most common diseases in the tropics and subtropics. Whilst mortality is a rare event when adequate supportive care can be provided, a large number of patients get hospitalised with dengue every year that places a heavy burden on local health systems. A better understanding of the support required at the time of hospitalisation is therefore of critical importance for healthcare planning, especially when resources are limited during major outbreaks.
Methods: Here we performed a retrospective analysis of clinical data from over 1500 individuals hospitalised with dengue in Vietnam between 2017 and 2019. Using a broad panel of potential biomarkers, we sought to evaluate robust predictors of prolonged hospitalisation periods.
Results: Our analyses revealed a lead-time bias, whereby early admission to hospital correlates with longer hospital stays - irrespective of disease severity. Importantly, taking into account the symptom duration prior to hospitalisation significantly affects observed associations between hospitalisation length and previously reported risk markers of prolonged stays, which themselves showed marked inter-annual variations. Once corrected for symptom duration, age, temperature at admission and elevated neutrophil-to-lymphocyte ratio were found predictive of longer hospitalisation periods.
Conclusion: This study demonstrates that the time since dengue symptom onset is one of the most significant predictors for the length of hospital stays, independent of the assigned severity score. Pre-hospital symptom durations need to be accounted for to evaluate clinically relevant biomarkers of dengue hospitalisation trajectories.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Recker et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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