Correlation of Thrombocytopenia and Length of Hospitalization in Dengue Child Patient

Riyadi Adrizain, Ananda Hanifah Husna, Andri Rezano

Abstract


Dengue virus infection (DVI) is one of the major health problems that cause 500 thousand patients hospitalized annually. Thrombocytopenia is one of the abnormal hematologic findings that is always found in DVI patients. This study aimed to determine the correlation of thrombocytopenia and length of hospitalization in dengue child patients. This retrospective analysis study used secondary data from seven major hospitals in Bandung with a total sampling method. The inclusion criteria were patients aged 0–18 years old diagnosed with dengue fever (DF), or dengue hemorrhagic fever (DHF), or dengue shock syndrome (DSS) who was admitted from January to December 2015 and excluded when there was comorbid as well as incomplete data. The correlation was analyzed by Spearman’s rank correlation test. There were 2,025 samples from a total of 5,712 DVI cases during 2015. Among those who admitted, most of the patients experienced severe thrombocytopenia (40%) with the average length of hospitalization was 4.84 days. This result was not much different from the patients with moderate (38.1%) and mild (21.9%) thrombocytopenia who were treated for an average of 4.13 days and 4.08 days, respectively. The analysis of correlation obtained a significant relationship between thrombocytopenia and length of hospitalization despite showing a weak correlation (r=0.231, p=0.001). In conclusion, there is a weak correlation between thrombocytopenia and length of hospitalization among dengue child patients.

 

KORELASI TROMBOSITOPENIA DENGAN LAMA RAWAT INAP PADA PASIEN ANAK TERINFEKSI VIRUS DENGUE

Infeksi virus dengue (IVD) merupakan salah satu masalah kesehatan utama yang menyebabkan 500 ribu pasien dirawat di rumah sakit setiap tahun. Trombositopenia adalah salah satu temuan abnormal hematologi yang selalu ditemukan pada pasien IVD. Penelitian ini bertujuan mengetahui korelasi trombositopenia dengan lama rawat inap pada pasien anak terinfeksi virus dengue. Penelitian analitik retrospektif ini menggunakan data sekunder tujuh rumah sakit besar di Kota Bandung dengan metode total sampling. Kriteria inklusi adalah pasien anak usia 0–18 tahun yang didiagnosis demam dengue (DD), atau demam berdarah dengue (DBD), atau sindrom syok dengue (SSD) yang dirawat dari bulan Januari hingga Desember 2015. Kriteria eksklusi meliputi komorbiditas dan data rekam medis yang tidak lengkap. Analisis dilakukan dengan uji korelasi rank Spearman. Terdapat 2.025 sampel dari total 5.712 kasus IVD selama tahun 2015. Di antara yang dirawat, sebagian besar pasien mengalami trombositopenia berat (40%) dengan lama rawat inap rerata 4,84 hari. Hasil ini tidak jauh berbeda dengan pasien dengan trombositopenia sedang (38,1%) dan ringan (21,9%) yang dirawat selama rerata 4,13 hari dan 4,08 hari masing-masing. Analisis korelasi diperoleh hubungan yang bermakna antara trombositopenia dan lama rawat inap meskipun dengan nilai korelasi lemah (r=0,231; p=0,001). Simpulan, terdapat korelasi lemah antara trombositopenia dan lama rawat inap pada pasien anak terinfeksi virus dengue.


Keywords


Dengue virus infection; infeksi virus dengue; lama rawat inap; length of hospitalization; thrombocytopenia; tromobositopenia

Full Text:

PDF

References


World Health Organization, Regional Office for South-East Asia. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever. Revised and Expanded Edition New Delhi, India: World Health Organization, Regional Office for South-East Asia; 2011.

de Azeredo EL, Monteiro RQ, de-Oliveira Pinto LM. Thrombocytopenia in dengue: interrelationship between virus and the imbalance between coagulation and fibrinolysis and inflammatory mediators. Mediators Inflamm. 2015;2015:313842.

da Silva NS, Undurraga EA, da Silva Ferreira ER, Estofolete CF, Nogueira ML. Clinical, laboratory, and demographic determinants of hospitalization due to dengue in 7613 patients: a retrospective study based on hierarchical models. Acta Trop. 2018;177:25–31.

Kaushik A, Pineda C, Kest H. Diagnosis and management of dengue fever in children. Pediatr Rev. 2010;31(4):e28–35.

Khalil MAM, Tan J, Ashhad M, Khalil MAU, Awan S, Rangasami M. Predictors of hospital stay and mortality in dengue virus infection-experience from Aga Khan University Hospital Pakistan. BMC Res Notes. 2014;7:473.

Utama IMS, Lukman N, Sukmawati DD, Alisjahbana B, Alam A, Murniati D, et al. Dengue viral infection in Indonesia: epidemiology, diagnostic challenges, and mutations from an observational cohort study. PLoS Negl Trop Dis. 2019;13(10):e0007785.

Kementerian Kesehatan Republik Indonesia. Profil kesehatan Indonesia tahun 2017. Jakarta: Kementerian Kesehatan Republik Indonesia; 2018.

Adrizain R, Setiabudi D, Chairulfatah A. The inappropriate use of antibiotics in hospitalized dengue virus-infected children with presumed concurrent bacterial infection in teaching and private hospitals in Bandung, Indonesia. PLoS Negl Trop Dis. 2019;13(6):e0007438.

Mallhi TH, Khan AH, Sarriff A, Adnan AS, Khan YH. Determinants of mortality and prolonged hospital stay among dengue patients attending tertiary care hospital: a cross-sectional retrospective analysis. BMJ Open. 2017;7(7):e016805.

Sirigadha KM, Khaleel M. A study on the laboratory profiles in dengue viral infection. Int J Curr Microbiol App Sci. 2017;6(1):387–95.

Tinambunan E, Suryani, Katu S, Halim R, Mubin AH, Sahyuddin. Correlation between hematologic profile and transaminase enzymes with hospitalization duration dengue. IOP Conf Ser Earth Environ Sci. 2018;125:012068.

Wan SW, Yang YW, Chu YT, Lin CF, Chang CP, Yeh TM, et al. Anti-dengue virus nonstructural protein 1 antibodies contribute to platelet phagocytosis by macrophages. Thromb Haemost. 2016;115(3):646–56.

Nikodemus S. Hubungan hasil pemeriksaan jumlah trombosit dengan lama rawat inap pada pasien demam berdarah dengue di Rumah Sakit Umum Pusat Haji Adam Malik (RSUPHAM) Medan [Internet]. Medan: Universitas Sumatera Utara; 2010 [cited 2019 November 4]. Available from: http://repository.usu.ac.id/handle/123456789/21402.

Adrizain R, Setiabudi D, Chairulfatah A. Hospital-based surveillance: accuracy, adequacy, and timeliness of dengue case report in Bandung, West Java, Indonesia of 2015. J Glob Infect Dis. 2018;10(4):201–5.

Tursinawati Y, Ramaningrum G, Aprilia DMI. Laboratory finding and clinical manifestation affecting the length of stay of hospitalization on children with dengue hemorrhagic fever. Pros Sem Nas Int Unimus. 2017;2017:130–5.

Mishra S, Ramanathan R, Agarwalla SK. Clinical profile of dengue fever in children: a study from Southern Odisha, India. Scientifica. 2016;2016:6391594.

Ferreira RAX, Kubelka CF, Velarde LGC, Matos JPS, Ferreira LC, Reid MM, et al. Predictive factors of dengue severity in hospitalized children and adolescents in Rio de Janeiro, Brazil. Rev Soc Bras Med Trop. 2018;51(6):753–60.

Shepard DS, Undurraga EA, Halasa YA. Economic and disease burden of dengue in Southeast Asia. PLoS Negl Trop Dis. 2013;7(2):e2055.

Nadjib M, Setiawan E, Putri S, Nealon J, Beucher S, Hadinegoro SR, et al. Economic burden of dengue in Indonesia. PLoS Negl Trop Dis. 2019;13(1):e0007038.

Kementerian Kesehatan Republik Indonesia. Profil kesehatan Indonesia tahun 2018. Jakarta: Kementerian Kesehatan Republik Indonesia; 2019.




DOI: https://doi.org/10.29313/gmhc.v8i2.5506

pISSN 2301-9123 | eISSN 2460-5441


Visitor since 19 October 2016: 

View My Stats


Free counters!


Global Medical and Health Communication is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.