Risk Factors for Mortality in Dengue Shock Syndrome (DSS)

Suharti, Catharina and Setiati , Tatty E and Gorp, Eric CM Van and Djokomoeljanto, Robert J and Trastotenojo, Moeljono S and Meer, Jos WM van der and Dolmans, Wil MV (2009) Risk Factors for Mortality in Dengue Shock Syndrome (DSS). Media Medika Indonesiana, 43 . pp. 213-219. ISSN 0126-1762

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Official URL: http://www.mediamedika.net

Abstract

Background: Dengue shock syndrome (DSS) is the most severe form of dengue hemorrhagic fever (DHF) and has a high mortality. There are two major pathological changes in DHF determining the severity of disease, plasma leakage and bleeding. Cytokines released during the immune response to dengue virus have been thought to be mediators of the process. Methods: The study involved 50 children with DSS, of whom 13 (26%) died. We investigated which clinical signs and laboratory findings are related to mortality. Results: We found that gastrointestinal bleeding and bilateral pleural effusion were significantly more frequent in non-survivors than in survivors (p<0.02 and p=0.0006, respectively). Also, mean admission levels of thrombin-antithrombin complexes (TATc) and plasminogen activator inhibitor type 1 (PAI-1), activation markers of coagulation and fibrinolysis, respectively, were significantly higher in non-survivors (p=0.004 and p=0.0006, respectively). In regression analysis, bilateral pleural effusion and admission levels of TATc were significantly associated with mortality (p=0.007 and p=0.048, respectively). Conclusions: Our data provide evidence for a relationship of mortality with pleural effusion, a marker of plasma leakage, and coagulation activation, both characteristic pathological changes in dengue shock syndrome.

Item Type:Article
Uncontrolled Keywords:Dengue shock syndrome, mortality, risk factor.
Subjects:R Medicine > R Medicine (General)
Divisions:UNDIP Journal > Media Medika Indonesia
Faculty of Medicine > Department of Medicine
Faculty of Medicine > Department of Medicine
ID Code:15234
Deposited By:Mr. Kedokteran Admin
Deposited On:25 Jun 2010 09:54
Last Modified:05 Aug 2010 23:25

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