The benign nature of dengue in the elderly in Singapore, 2004
Abstract number: P1633
Lye D.C., Lee V., Sun Y., Leo Y.S.
Objectives: Children are at higher risk of dengue haemorrhagic fever (DHF). However, increased mortality in older adults was noted in Cuba and Puerto Rico. In Singapore, patients 55 years comprised 10.1% of dengue cases in 2005 and 22.8% in 2006. This study aims to determine if older dengue patients in Singapore have greater morbidity and mortality.
Methods: All dengue patients admitted to our department in 2004 were retrospectively reviewed. Demographic, clinical, laboratory and outcome data of dengue patients 60 years and <60 years were collected and compared. Using data from entire clinical course, all cases were re-classified into dengue fever and DHF based on World Health Organisation criteria.
Results: Of 1971 laboratory-confirmed dengue cases, 66 were 60 years. Older patients were significantly less likely to be male (44% vs. 66%), and more likely to be Singaporean by nationality (91% vs. 61%), have diabetes (17% vs. 2%), hypertension (48% vs. 4%), ischaemic heart disease (6% vs. 0.1%), hyperlipidaemia (18% vs. 1%) and secondary dengue infections (64% vs. 34%). Clinical features were similar except older patients were less likely to report fever (92% vs. 99%). Older patients were significantly less likely to have leukopenia (32% vs. 51%) and haemoconcentration (0 vs. 5%) on admission. Older patients were not more likely to develop DHF, bleeding, hypotension, severe thrombocytopenia and transaminitis. However, older patients were significantly more likely to receive platelet transfusion (23% vs. 12%). Their length of hospital stay, risk of intensive care unit admission and death were not statistically different.
Conclusions: Despite greater co-morbidity and secondary dengue infection, older dengue patients in Singapore did not have greater morbidity and mortality.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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