[Clinical evolution of dengue in hospitalized patients]

Dengue hemorrhagic fever has extended to every tropical and subtropical area of the world, resulting in a half million hospitalizations every year. This disease appears to affect increasing numbers of adolescents and young adults.

The clinical characteristics were described for adult and pediatric dengue inpatients to establish risk factors associated with bad prognosis.

A cohort of dengue inpatients of years 2006 and 2007 was evaluated retrospectively at "Clínica Chicamocha", a high level hospital in Bucaramanga, Colombia.

Of 328 patients evaluated, 165 were female and 163 were male with a median age of 25 years. Dengue hemorrhagic fever was diagnosed in 116 patients, of which 113 were classified grade II. Of the 212 patients with dengue fever, 156 developed signs of plasma leakage, bleeding or thrombocytopenia. A positive serology was indicated in 82.4% of the patients. Inpatients with dengue hemorrhagic fever were younger (20.1 vs. 25.7 years, p<0.0054). Both lowest level of platelets and highest hematocrit were reached at the sixth day of illness. Children presented the typical symptoms of dengue less frequently, but demonstrated a greater proportion of ascites, pleural effusion and bleeding, and a higher risk of developing respiratory distress (RR=3.59, 95%CI 1.3-9.9, p<0.014) and hypotension (RR=10.77, 95%CI 5.56-20.86, p<0.001).

Age was the most determinant factor of severity in dengue inpatients. In addition, a combination of particular symptoms and laboratory data at the day of admission may predict the development of complications.