Publication: Incidence and clinical outcome of acute liver failure caused by dengue in a hospital for tropical diseases, Thailand
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Issued Date
2016-12-01
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ISSN
00029637
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2-s2.0-85005990087
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.95, No.6 (2016), 1338-1344
Suggested Citation
Khin Kye Mon, Apichart Nontprasert, Chatporn Kittitrakul, Pisit Tangkijvanich, Wattana Leowattana, Kittiyod Poovorawan Incidence and clinical outcome of acute liver failure caused by dengue in a hospital for tropical diseases, Thailand. American Journal of Tropical Medicine and Hygiene. Vol.95, No.6 (2016), 1338-1344. doi:10.4269/ajtmh.16-0374 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/40776
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Title
Incidence and clinical outcome of acute liver failure caused by dengue in a hospital for tropical diseases, Thailand
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Abstract
Copyright © 2016 by The American Society of Tropical Medicine and Hygiene. Acute liver failure is an atypical manifestation of dengue with a high mortality. We performed a retrospective cohort study at the Hospital for Tropical Diseases, Bangkok, Thailand. In total, 1,926 patients with serologically confirmed dengue were enrolled in the study from 2011 to 2015. Of these, six patients presented with acute liver failure, four died, and two survived. The incidence of dengue-associated acute liver failure was 0.31%. Dengue-associated acute liver failure was most common among young adults (median age, 29 years). The median duration from onset of fever to development of acute liver failure was 7.5 days. Patients with the severe stage of dengue had a higher risk of developing acute liver failure (P < 0.001). The baseline risk factors associated with the development of acute liver failure were an age of ? 40 years (odds ratio [OR] = 1.5, 95% confidence interval [CI] = 1.1-2.0, P < 0.05), a > 10% ratio of atypical lymphocytes (OR = 2.3, 95% CI = 1.8-3.0, P < 0.001), and a platelet count of < 50,000 mm3 (OR = 2.8, 95% CI = 2.2-3.6, P < 0.001). The incidence of acute liver failure in patients with dengue was quite low, but its impact on morbidity, mortality, and poor clinical outcomes was significant. In summary, this study indicates that various baseline risk factors are associated with acute liver failure in patients with dengue.