Atypical presentations of dengue disease in the elderly visiting the ED

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Abstract

AbstractObjective The objective was to compare the clinical characteristics of elderly and young adult patients with dengue in the emergency department (ED). Methods Demographic characteristics, clinical presentation, disease severity, laboratory characteristics, and outcomes were analyzed prospectively as a case-control study. Results Of the 193 adults with serologically confirmed dengue disease in 2007, 31 (16.1%) were elderly patients (aged ≥ 65) and 162 were young adults (aged < 65). More dengue hemorrhagic fever (12.9% vs 2.5%, P =.02), a longer ED stay (13.3 vs 8.6 hours, P =.004), a longer hospital stay (7.4 vs 3.4 days, P <.001), a higher Simplified Acute Physiology Score II in the ED (29.7 vs 17.4, P <.001), and a higher rate of at least 1 comorbidity (61.8 vs 22.8%, P <.001) were found in the elderly. However, the length of the intensive care unit stay (elderly 0.7 vs young adults 0.3 day, P =.47) and the 14-day mortality rate (0% vs 0.6%, P = 1.00) were similar. Of note, in terms of clinical presentations of dengue in the ED, there were more elderly patients with isolated fever (41.9% vs 17.9%, P =.003) and fewer with typical presentation (41.9% vs 75.9%, P = <.001) than there were young adults. Conclusions The present study found a higher number of atypical presentations, a longer hospitalization, and a higher degree of clinical illness in elderly patients with dengue.

Original languageEnglish
Pages (from-to)783-787
Number of pages5
JournalAmerican Journal of Emergency Medicine
Volume31
Issue number5
DOIs
Publication statusPublished - 2013 May 1

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Dengue
Hospital Emergency Service
Young Adult
Severe Dengue
Intensive Care Units
Case-Control Studies
Comorbidity
Length of Stay
Hospitalization
Fever
Demography
Mortality

All Science Journal Classification (ASJC) codes

  • Emergency Medicine

Cite this

@article{21d3384041154d95b8858adb07f5ae59,
title = "Atypical presentations of dengue disease in the elderly visiting the ED",
abstract = "AbstractObjective The objective was to compare the clinical characteristics of elderly and young adult patients with dengue in the emergency department (ED). Methods Demographic characteristics, clinical presentation, disease severity, laboratory characteristics, and outcomes were analyzed prospectively as a case-control study. Results Of the 193 adults with serologically confirmed dengue disease in 2007, 31 (16.1{\%}) were elderly patients (aged ≥ 65) and 162 were young adults (aged < 65). More dengue hemorrhagic fever (12.9{\%} vs 2.5{\%}, P =.02), a longer ED stay (13.3 vs 8.6 hours, P =.004), a longer hospital stay (7.4 vs 3.4 days, P <.001), a higher Simplified Acute Physiology Score II in the ED (29.7 vs 17.4, P <.001), and a higher rate of at least 1 comorbidity (61.8 vs 22.8{\%}, P <.001) were found in the elderly. However, the length of the intensive care unit stay (elderly 0.7 vs young adults 0.3 day, P =.47) and the 14-day mortality rate (0{\%} vs 0.6{\%}, P = 1.00) were similar. Of note, in terms of clinical presentations of dengue in the ED, there were more elderly patients with isolated fever (41.9{\%} vs 17.9{\%}, P =.003) and fewer with typical presentation (41.9{\%} vs 75.9{\%}, P = <.001) than there were young adults. Conclusions The present study found a higher number of atypical presentations, a longer hospitalization, and a higher degree of clinical illness in elderly patients with dengue.",
author = "Lee, {Ching Chi} and Hsu, {Hsiang Chin} and Chang, {Chia Ming} and Hong, {Ming Yuan} and Ko, {Wen Chien}",
year = "2013",
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doi = "10.1016/j.ajem.2013.01.011",
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T1 - Atypical presentations of dengue disease in the elderly visiting the ED

AU - Lee, Ching Chi

AU - Hsu, Hsiang Chin

AU - Chang, Chia Ming

AU - Hong, Ming Yuan

AU - Ko, Wen Chien

PY - 2013/5/1

Y1 - 2013/5/1

N2 - AbstractObjective The objective was to compare the clinical characteristics of elderly and young adult patients with dengue in the emergency department (ED). Methods Demographic characteristics, clinical presentation, disease severity, laboratory characteristics, and outcomes were analyzed prospectively as a case-control study. Results Of the 193 adults with serologically confirmed dengue disease in 2007, 31 (16.1%) were elderly patients (aged ≥ 65) and 162 were young adults (aged < 65). More dengue hemorrhagic fever (12.9% vs 2.5%, P =.02), a longer ED stay (13.3 vs 8.6 hours, P =.004), a longer hospital stay (7.4 vs 3.4 days, P <.001), a higher Simplified Acute Physiology Score II in the ED (29.7 vs 17.4, P <.001), and a higher rate of at least 1 comorbidity (61.8 vs 22.8%, P <.001) were found in the elderly. However, the length of the intensive care unit stay (elderly 0.7 vs young adults 0.3 day, P =.47) and the 14-day mortality rate (0% vs 0.6%, P = 1.00) were similar. Of note, in terms of clinical presentations of dengue in the ED, there were more elderly patients with isolated fever (41.9% vs 17.9%, P =.003) and fewer with typical presentation (41.9% vs 75.9%, P = <.001) than there were young adults. Conclusions The present study found a higher number of atypical presentations, a longer hospitalization, and a higher degree of clinical illness in elderly patients with dengue.

AB - AbstractObjective The objective was to compare the clinical characteristics of elderly and young adult patients with dengue in the emergency department (ED). Methods Demographic characteristics, clinical presentation, disease severity, laboratory characteristics, and outcomes were analyzed prospectively as a case-control study. Results Of the 193 adults with serologically confirmed dengue disease in 2007, 31 (16.1%) were elderly patients (aged ≥ 65) and 162 were young adults (aged < 65). More dengue hemorrhagic fever (12.9% vs 2.5%, P =.02), a longer ED stay (13.3 vs 8.6 hours, P =.004), a longer hospital stay (7.4 vs 3.4 days, P <.001), a higher Simplified Acute Physiology Score II in the ED (29.7 vs 17.4, P <.001), and a higher rate of at least 1 comorbidity (61.8 vs 22.8%, P <.001) were found in the elderly. However, the length of the intensive care unit stay (elderly 0.7 vs young adults 0.3 day, P =.47) and the 14-day mortality rate (0% vs 0.6%, P = 1.00) were similar. Of note, in terms of clinical presentations of dengue in the ED, there were more elderly patients with isolated fever (41.9% vs 17.9%, P =.003) and fewer with typical presentation (41.9% vs 75.9%, P = <.001) than there were young adults. Conclusions The present study found a higher number of atypical presentations, a longer hospitalization, and a higher degree of clinical illness in elderly patients with dengue.

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