Clinical predictors for complicated forms of dengue fever in patients of the Colombian Amazon Region

Resumen

Introduction: Dengue is a viral infection caused by one of the four serotypes of the dengue virus and it is transmitted among humans by the bite of the female Aedes aegypti mosquito. Clinically this infection can be asymptomatic or to course with a range of severity, dengue without or with signs of alarm to severe forms, serious dengue. Objective: To determine in 2944 patients with confirmed diagnosis of dengue which clinical manifestations would be more useful to predict the appearance of dengue with alarm signs and severe dengue in the population of the of the Colombian Amazon Region. Results: The clinical manifestations of warning in dengue that were predictive for dengue with alarm signs were abdominal pain (P< 0.0001, OR=44, IC-95% 32-59), vomiting (P< 0.0001, OR=38, IC-95% 24-61), diarrhea (P< 0.0001, OR=18, IC-95% 12-29), altered state of consciousness (P< 0.0001, OR=12, IC-95% 5-31) , mucosal bleeding (P< 0.0001, OR=23, IC-95% 10-52), thrombocytopenia (P< 0.0001, OR=41, IC-95% 29-56). With respect to predictors of severe dengue, it was shown that bleeding and hemodynamic instability (P< 0.0001, OR=1.2, CI-95% 1.1-1.3) would be a predictor in the detection of this clinical form of dengue. Conclusions: Manifestations such as gastrointestinal alterations, alterations in the state of consciousness, bleeding and thrombocytopenia would be clinical predictors of dengue fever with alarm signs. In severe dengue, the presence of hemorrhages and hemodynamic instability would be predictive in the detection of this clinical form of dengue.