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Validation of shock index for predicting mortality in older patients with dengue fever

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Abstract

Background

Older adults have a higher mortality for dengue fever (DF). However, the best method for predicting mortality is still unclear.

Aims

We conducted this study to evaluate the shock index (SI) for this issue.

Methods

A retrospective case–control study was conducted by recruiting older patients (≥ 65 years old) with DF who visited the study hospital in southern Taiwan during the 2015 DF outbreak. Demographic data, vital signs, past histories, decision groups, complications, and mortality were included in the analyses. We evaluated the accuracy of SI ≥ 1 for predicting 30-day mortality in this population.

Results

A total of 626 patients with a mean age of 74.1 years and nearly equal sex distribution were recruited. The mean of SI (± standard deviation [SD]) was 0.6 (± 0.2) and patients with a SI ≥ 1 accounted for 3.5% of the total patients. Logistic regression showed that patients with SI ≥ 1 had a higher mortality than those with SI < 1 (odds ratio: 8.49; 95% confidence interval: 1.76–17.92). The area under the receiver-operating characteristic was 0.76, and the Hosmer–Lemeshow goodness of fit test was 0.48. The SI ≥ 1 had a sensitivity, specificity, positive predictive value, and negative predictive value of 14.8%, 97.0%, 18.2%, and 96.2% for predicting mortality.

Conclusions

The SI ≥ 1 is an easy tool that can be potentially used to predict 30-day mortality in older DF patients, especially in DF outbreak. It has a high specificity and negative predictive value for excluding patients with high-risk mortality.

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Acknowledgements

We thank Enago for their English language editing service for this work.

Funding

Nil.

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Authors and Affiliations

Authors

Contributions

THT, HKH, JYC, and CC Huang designed and conceived this study and wrote the manuscript. JYC performed the statistical analysis and wrote the manuscript. CC Hsu and HJL provided professional suggestions and wrote the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Jui-Yuan Chung or Chien-Cheng Huang.

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Conflict of interest

The authors declare no conflicts of interest.

Statement of human and animal rights

This study was approved by the institutional review board at CMMC.

Informed consent

The need for informed consent from the patients was waived due to the observational study setting.

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Tan, TH., Huang, HK., Hsu, CC. et al. Validation of shock index for predicting mortality in older patients with dengue fever. Aging Clin Exp Res 33, 635–640 (2021). https://doi.org/10.1007/s40520-020-01563-7

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