Predictors of mortality in individuals infected with dengue: An Indian case study

Abstract

Background and objectives

Dengue infection and its associated complication contributes to a significant number of deaths as per World Health Organization (WHO) statistics. The aim of the study is to identify Predictors associated with mortality in Dengue infection.

Materials and methods

In this prospective observational study conducted at the tertiary care hospitals of north India from August 2023 to December 2024, confirmed cases of dengue fever with a duration of less than seven days were recruited. Patients classified into Survivors or non-survivors, variables that were found to have statistically significant associations on univariate analysis were subjected to multivariate analysis by logistic regression by enter method for predictors of dengue mortality.

Results

A total of 158 dengue patients were recruited of which 18 (11.4%) died from the disease. Altered mental status, dyspnea at rest, and decreased urine output were significantly more frequent among non-survivors. Regarding laboratory parameters, non-survivor group exhibited significantly elevated levels of total leukocyte count, urea, creatinine, liver enzymes and International normalized ratio. Application of logistic regression using 3 factors-qSOFA (quick sequential organ failure assessment), creatinine and ferritin were performed which showed a statistically significant association with creatinine and ferritin. Odd Ratio (OR) for creatinine 1.449 indicates that for every unit increase in creatinine, the odds of mortality increase by 44.9%. Although the OR is exactly 1, the tight CI around 1 suggests that elevated ferritin is associated with mortality, but with a small effect size (p – 0.047).

Conclusions

The presence of raised creatinine and elevated serum ferritin were predictors associated with a higher risk of mortality.