Clinical and laboratory characteristics and risk factors for fatality in elderly patients with dengue hemorrhagic fever

Abstract

To better understand the clinical and laboratory characteristics and to identify risk factor(s) for fatality in elderly patients with dengue hemorrhagic fever (DHF), 66 elderly (age > or = 65 years) and 241 non-elderly adults (age, 19-64 years) with DHF were retrospectively analyzed. Compared with non-elderly adults, elderly individuals had significantly lower incidences of fever (P = 0.002), abdominal pain (P = 0.003), bone pain (P < 0.001), and skin rashes (P = 0.002); higher frequencies of concurrent bacteremia (P = 0.049), gastrointestinal bleeding (P = 0.044), acute renal failure (P = 0.001), and pleural effusion (P < 0.010); higher incidence of prolonged prothrombin time (P = 0.025); lower mean hemoglobin level (P < 0.001); longer hospitalization (P = 0.049); and a higher fatality rate (P = 0.006). Five elderly patients with DHF died. When compared with non-fatal elderly patients with DHF, a significant higher frequency in men (P = 0.019), those with chronic obstructive pulmonary disease (P = 0.008), those with dengue shock syndrome (DSS; P < 0.001), and those with acute renal failure (P < 0.001) was found in the elderly counterparts that died. Multivariate analysis showed that only DSS (odd ratio = 77.33, P = 0.001) was an independent risk factor for fatality in elderly patients.