{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:09:24Z","timestamp":1787065764255,"version":"build-2736575974"},"reference-count":37,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2,6]]},"abstract":"<jats:p>According to the World Health Organization, 98% of fatal dengue cases can be prevented; however, endemic countries such as Colombia have recorded higher case fatality rates during recent epidemics. We aimed to identify the predictors of mortality that allow risk stratification and timely intervention in patients with dengue. We conducted a hospital-based, case\u2013control (1:2) study in two endemic areas of Colombia (2009\u20132015). Fatal cases were defined as having either 1) positive serological test (IgM or NS1), 2) positive virological test (RT-PCR or viral isolation), or 3) autopsy findings compatible with death from dengue. Controls (matched by state and year) were hospitalized nonfatal patients and had a positive serological or virological dengue test. Exposure data were extracted from medical records by trained staff. We used conditional logistic regression (adjusting for age, gender, disease\u2019s duration, and health-care provider) in the context of multiple imputation to estimate exposure to case\u2013control associations. We evaluated 110 cases and 217 controls (mean age: 35.0 versus 18.9; disease\u2019s duration pre-admission: 4.9 versus 5.0 days). In multivariable analysis, retro-ocular pain (odds ratios [OR] = 0.23), nausea (OR = 0.29), and diarrhea (OR = 0.19) were less prevalent among fatal than nonfatal cases, whereas increased age (OR = 2.46 per 10 years), respiratory distress (OR = 16.3), impaired consciousness (OR = 15.9), jaundice (OR = 32.2), and increased heart rate (OR = 2.01 per 10 beats per minute) increased the likelihood of death (AUC: 0.97, 95% confidence interval: 0.96, 0.99). These results provide evidence that features of severe dengue are associated with higher mortality, which strengthens the recommendations related to triaging patients in dengue-endemic areas.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0323","type":"journal-article","created":{"date-parts":[[2019,1,15]],"date-time":"2019-01-15T02:08:38Z","timestamp":1547518118000},"page":"411-419","source":"Crossref","is-referenced-by-count":19,"title":["Clinical Indicators of Fatal Dengue in Two Endemic Areas of Colombia: A Hospital-Based Case\u2013Control Study"],"prefix":"10.4269","volume":"100","author":[{"given":"Elsa M.","family":"Rojas","sequence":"first","affiliation":[{"name":"Center for Epidemiological Research, Universidad Industrial de Santander-UIS, Bucaramanga, Colombia;"},{"name":"Info Vida, Bucaramanga, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor M.","family":"Herrera","sequence":"additional","affiliation":[{"name":"Center for Epidemiological Research, Universidad Industrial de Santander-UIS, Bucaramanga, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda C.","family":"Miranda","sequence":"additional","affiliation":[{"name":"Center for Epidemiological Research, Universidad Industrial de Santander-UIS, Bucaramanga, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana Patricia","family":"Rojas","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana M.","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Center for Epidemiological Research, Universidad Industrial de Santander-UIS, Bucaramanga, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Pallares","sequence":"additional","affiliation":[{"name":"Hospital Universitario del Valle, Cali, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara M.","family":"Cobos","sequence":"additional","affiliation":[{"name":"Hospital Universitario del Valle, Cali, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lissethe","family":"Pardo","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Salud, Bogot\u00e1, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"G\u00e9lvez","sequence":"additional","affiliation":[{"name":"Center for Epidemiological Research, Universidad Industrial de Santander-UIS, Bucaramanga, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"P\u00e1ez","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Salud, Bogot\u00e1, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio C.","family":"Mantilla","sequence":"additional","affiliation":[{"name":"Department of Pathology, Universidad Industrial de Santander-UIS, Bucaramanga, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anilza","family":"Bonelo","sequence":"additional","affiliation":[{"name":"Emerging Viruses and Disease-VIREM, Universidad del Valle, Cali, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Parra","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Salud, Bogot\u00e1, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis A.","family":"Villar","sequence":"additional","affiliation":[{"name":"Center for Epidemiological Research, Universidad Industrial de Santander-UIS, Bucaramanga, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Nature","first-page":"504","article-title":"The global distribution and burden of dengue","volume":"496","author":"Bhatt","year":"2013"},{"key":"b2","series-title":"Lancet Infect Dis","first-page":"1113","article-title":"Global burden on neglected tropical diseases","volume":"16","author":"Qian","year":"2016"},{"key":"b3","series-title":"Curr Infect Dis Rep","first-page":"457","article-title":"Dengue: update on epidemiology","volume":"17","author":"Wilson","year":"2015"},{"key":"b4","author":"World Health Organization"},{"key":"b5","series-title":"PLoS Negl Trop Dis","first-page":"e0005025","article-title":"Enhanced surveillance for fatal dengue-like acute febrile illness in Puerto Rico, 2010\u20132012","volume":"10","author":"Tomashek","year":"2016"},{"key":"b6","series-title":"Am J Trop Med Hyg","first-page":"670","article-title":"Determinants of mortality from 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