The clinical profile and risk factors for mortality in
dengue fever have evolved over the years. The all-cause mortality in admitted
dengue patients is around 6%. We aimed to evaluate the recent change in trends of the clinical characteristics and risk factors for in-hospital mortality in adults with
dengue fever. This is a retrospective study on adults with confirmed
dengue fever admitted in a medical unit of a tertiary care center in North India. Medical records of confirmed
dengue fever patients admitted between January 2011, and December 2016 were reviewed. Chi-squared tests with Bonferroni correction for multiple testing were used to identify risk factors for mortality. 232 records were included, of which 66.8% were males. The mean age was 31.6 ± 14 years. There were 17 deaths with an all-cause mortality rate of 7.3% with 76.5% being classified as
severe dengue at admission. Among the 17 mortality cases,
dyspnea (47%),
tachypnea (86.7%), leucocytosis (58.8%), raised
urea (80%), and elevated serum
creatinine (52.9%) at presentation were significantly associated with mortality (p < 0.001).
Shock at any time during the
hospital stay (58.8%) was also found to be significantly associated with mortality (p < 0.001). We found that
dyspnea,
tachypnea,
acute kidney injury, and leucocytosis at presentation was significantly associated with in-hospital mortality. Based on our results, we recommend aggressive management of patients with
severe dengue and those with mild/moderate disease with the above risk factors.