Prognostic factors for mortality in children with severe dengue: A single-centre retrospective cohort study

Background: Severe dengue is a serious manifestation of dengue infection and one of the causes of death in children. Recognizing the prognostic factors for death in severe dengue, based on the 2009 WHO guidelines, can help provide appropriate management to reduce the death rate. Objective: To determ...

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Main Authors: Lidwina Elisabeth Setiana Salombe, Nurnaningsih, Surya Adhi, Eggi Arguni
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Heliyon
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405844025014021
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author Lidwina Elisabeth Setiana Salombe
Nurnaningsih
Surya Adhi
Eggi Arguni
author_facet Lidwina Elisabeth Setiana Salombe
Nurnaningsih
Surya Adhi
Eggi Arguni
author_sort Lidwina Elisabeth Setiana Salombe
collection DOAJ
description Background: Severe dengue is a serious manifestation of dengue infection and one of the causes of death in children. Recognizing the prognostic factors for death in severe dengue, based on the 2009 WHO guidelines, can help provide appropriate management to reduce the death rate. Objective: To determine the prognostic factors for mortality in pediatric patients with severe dengue admitted to Dr. Sardjito General Hospital, Yogyakarta. Methods: We retrospectively collected data on children with severe dengue from January 2017 to December 2022 at Dr. Sardjito Hospital. Bivariate and multivariate analyses were performed to determine the prognostic factors that significantly impacted the outcome of death. Results: There were 120 eligible patients with severe dengue during the study period; 17 subjects (14.2 %) died and 103 subjects (85.8 %) survived. Multivariate analysis showed that mechanical ventilation (RR 8.97, 95 % CI 1.31–103.21, p 0.025), fluid overload >10 % (RR 7.56, 95 % CI 1.15–49.72, p-value = 0.035), and vasoactive-inotropic score (VIS) ≥13.75 (RR 13.56, 95 % CI 1.78–103.21 p-value = 0.012) were the prognostic factors for mortality in pediatric patients with severe dengue. Conclusion: Mechanical ventilation, excess fluid and the need for multiple vasoactive drugs are the prognostic factors for mortality in severe dengue in children.
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spelling doaj-art-cf94f68743ee483891d57d0a3a9111dc2025-08-20T03:15:16ZengElsevierHeliyon2405-84402025-04-01119e4302110.1016/j.heliyon.2025.e43021Prognostic factors for mortality in children with severe dengue: A single-centre retrospective cohort studyLidwina Elisabeth Setiana Salombe0 Nurnaningsih1Surya Adhi2Eggi Arguni3Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia; Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, IndonesiaDepartment of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, IndonesiaFaculty of Medicine, Nursing, and Health Science, Monash University, IndonesiaDepartment of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia; Corresponding author. Jalan Farmako, Mlati, Sleman, Daerah Istimewa, Yogyakarta, 55281, Indonesia.Background: Severe dengue is a serious manifestation of dengue infection and one of the causes of death in children. Recognizing the prognostic factors for death in severe dengue, based on the 2009 WHO guidelines, can help provide appropriate management to reduce the death rate. Objective: To determine the prognostic factors for mortality in pediatric patients with severe dengue admitted to Dr. Sardjito General Hospital, Yogyakarta. Methods: We retrospectively collected data on children with severe dengue from January 2017 to December 2022 at Dr. Sardjito Hospital. Bivariate and multivariate analyses were performed to determine the prognostic factors that significantly impacted the outcome of death. Results: There were 120 eligible patients with severe dengue during the study period; 17 subjects (14.2 %) died and 103 subjects (85.8 %) survived. Multivariate analysis showed that mechanical ventilation (RR 8.97, 95 % CI 1.31–103.21, p 0.025), fluid overload >10 % (RR 7.56, 95 % CI 1.15–49.72, p-value = 0.035), and vasoactive-inotropic score (VIS) ≥13.75 (RR 13.56, 95 % CI 1.78–103.21 p-value = 0.012) were the prognostic factors for mortality in pediatric patients with severe dengue. Conclusion: Mechanical ventilation, excess fluid and the need for multiple vasoactive drugs are the prognostic factors for mortality in severe dengue in children.http://www.sciencedirect.com/science/article/pii/S2405844025014021ChildrenMortalityPrognostic factorsSevere dengue
spellingShingle Lidwina Elisabeth Setiana Salombe
Nurnaningsih
Surya Adhi
Eggi Arguni
Prognostic factors for mortality in children with severe dengue: A single-centre retrospective cohort study
Heliyon
Children
Mortality
Prognostic factors
Severe dengue
title Prognostic factors for mortality in children with severe dengue: A single-centre retrospective cohort study
title_full Prognostic factors for mortality in children with severe dengue: A single-centre retrospective cohort study
title_fullStr Prognostic factors for mortality in children with severe dengue: A single-centre retrospective cohort study
title_full_unstemmed Prognostic factors for mortality in children with severe dengue: A single-centre retrospective cohort study
title_short Prognostic factors for mortality in children with severe dengue: A single-centre retrospective cohort study
title_sort prognostic factors for mortality in children with severe dengue a single centre retrospective cohort study
topic Children
Mortality
Prognostic factors
Severe dengue
url http://www.sciencedirect.com/science/article/pii/S2405844025014021
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AT suryaadhi prognosticfactorsformortalityinchildrenwithseveredengueasinglecentreretrospectivecohortstudy
AT eggiarguni prognosticfactorsformortalityinchildrenwithseveredengueasinglecentreretrospectivecohortstudy