{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T02:43:57Z","timestamp":1781491437800,"version":"3.54.1"},"reference-count":29,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,8,2]]},"abstract":"<jats:p>People in southern Taiwan experienced two major dengue outbreaks in 2014 and 2015. The mortality and clinical features were very different between these 2 years. Dengue virus serotype 1 (DENV-1) caused epidemic outbreak in 2014 and DENV-2 was predominant in 2015. The characteristics of dengue hemorrhagic fever (DHF) cases in the 2 years was analyzed. We conducted a retrospective chart review to analyze the clinical and laboratory features of 206 adult patients with DHF in southern Taiwan in 2014 and 2015. The mortality rate of DHF cases in 2015 was higher than that of cases in 2014 (38.7% versus 12.4%, <jats:italic>P<\/jats:italic> &lt; 0.0001). Compared with cases in 2014, DHF cases in 2015 had more complications, such as gastrointestinal bleeding (78.5% versus 61.9%, <jats:italic>P<\/jats:italic> = 0.01), severe hepatitis (30.1% versus 8%, <jats:italic>P<\/jats:italic> &lt; 0.0001), and myocarditis (14% versus 0.9%, <jats:italic>P<\/jats:italic> &lt; 0.0001). Among the mortality cases, diabetes, chronic renal failure, proton-pump inhibitors using, platelet transfusion, and Charlson comorbidity index score (Charlson score) were also higher in 2015. Multivariate analysis for the mortality cases revealed that the risk factors were Charlson score \u2265 5 (<jats:italic>P<\/jats:italic> = 0.02, odds ratio [OR] = 4.07, 95% confidence interval [CI] = 1.244\u201313.307), severe hepatitis (<jats:italic>P<\/jats:italic> &lt; 0.0001, OR = 11.97, 95% CI = 3.831\u201337.396), and acute renal failure (<jats:italic>P<\/jats:italic> &lt; 0.0001, OR = 98.76, 95% CI = 10.847\u2013899.22). DHF cases in 2015 had higher mortality and more complications, such as gastrointestinal bleeding, severe hepatitis, and myocarditis, than in 2014 in southern Taiwan. In the 2-year DHF case series, Charlson score \u2265 5, severe hepatitis, and acute renal failure were independent significant variables for mortality.<\/jats:p>","DOI":"10.4269\/ajtmh.16-1018","type":"journal-article","created":{"date-parts":[[2017,6,13]],"date-time":"2017-06-13T07:00:32Z","timestamp":1497337232000},"page":"361-368","source":"Crossref","is-referenced-by-count":29,"title":["Differences in Mortality and Clinical Manifestations of Dengue Hemorrhagic Fever in Taiwan in Different Years: A Comparison for Cases in 2014 and 2015 Epidemics"],"prefix":"10.4269","volume":"97","author":[{"given":"Ko","family":"Chang","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;"},{"name":"Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University Kaohsiung, Taiwan;"},{"name":"Department of Internal Medicine, Kaohsiung Medical University Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Hao","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ing-Kit","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Liang","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;"},{"name":"Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;"},{"name":"Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tun-Chieh","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;"},{"name":"Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University Kaohsiung, Taiwan;"},{"name":"Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping-Chang","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, St. Joseph Hospital, Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiao-Cheng","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yuan\u2019s General Hospital, Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin-Liang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hsing","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Pediatric, Kaohsiung Medical University Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng-Chieh","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;"},{"name":"Department of Internal Medicine, Kaohsiung Medical University Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Ying","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Kaohsiung Medical University Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Chi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of laboratory Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deng-Chyang","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;"},{"name":"Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University Kaohsiung, Taiwan;"},{"name":"Department of Dermatology, Kaohsiung Medical University Kaohsiung, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Hsu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yuan\u2019s General Hospital, Kaohsiung, Taiwan;"},{"name":"School of Medicine, Graduate Institute of Medicine, Sepsis Research Institute, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;"},{"name":"Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"BMJ","first-page":"1563","article-title":"Dengue: an escalating problem","volume":"324","author":"Gibbons","year":"2002"},{"key":"b2","series-title":"World Health Stat Q","first-page":"161","article-title":"Global situation of dengue and dengue hemorrhagic fever, and its emergence in the Americas","volume":"50","author":"Pinheiro","year":"1997"},{"key":"b3","series-title":"Lancet","first-page":"170","article-title":"The WHO dengue classification and case definitions: Time for a reassessment","volume":"368","author":"Deen","year":"2006"},{"key":"b4","series-title":"J Microbiol Immunol Infect","first-page":"121","article-title":"Clinical characteristics of dengue and dengue hemorrhagic fever in a medical center of southern Taiwan during the 2002 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