594. Blood Pressure Trend in Hospitalized Adult Dengue Patients
Session: Poster Abstract Session: Oh One World: Infections from Near and Far
Thursday, October 27, 2016
Room: Poster Hall
Background: Monitoring of blood pressure is an important part of management of dengue illness. We examined differences in time trend of systolic (SBP) and diastolic blood pressure (DBP) in patients with and without severe dengue (SD), dengue hemorrhagic fever (DHF) and pre-existing hypertension (HT), and elderly versus non-elderly patients.

Methods: We studied 6070 hospitalized adult dengue patients with confirmed by polymerase chain reaction or clinical criteria plus positive dengue serology from 2005 to 2008. Dengue severity was defined according to World Health Organization 1997 and 2009 guidelines. We used Bayesian hierarchical Markov models to compare the daily mean SBP and DBP between different subgroups. Analysis was conducted by day of defervescence (defined as day 0), and day of illness onset (defined as day 1) respectively.

Results: SBP decreased to a nadir during the critical phase before defervescence and was significantly lower for patients with SD or DHF, compared with patients without. DBP increased marginally more for patients with SD or DHF in the critical phase before defervescence. By day of defervescence, comparison of patients with and without SD showed significant difference in SBP from day -6 to day +6, except days +1, +3 and +5, and similarly in DBP except days 0, and +4 to +6. Comparison of patients with and without DHF showed significant difference in SBP from day -6 to day -1, but for DBP, significant difference was noted from day -6 to day +6, except day -2 to day 0. By day of illness, SBP differed significantly between patients with and without SD from days 1 to 10, and DBP from days 7 to 12. Between patients with and without DHF, SBP differed significantly on illness days 1, 2, 4 to 7, while DBP from days 7 to 12. Comparison of elderly versus non-elderly, and patients with and without HT in DHF and SD showed a trend of higher SBP and DBP throughout their hospitalization, by days of defervescence and days of illness.

Conclusion: In SD and DHF, SBP decreased to a nadir around the day of defervescence, and recovered to a level exceeding that in febrile phase by days 2 or 3 post-defervescence. Elderly patients and patients with pre-existing HT maintained higher SBP and DBP throughout the duration of illness in DHF and SD.

David Lye, FRACP, FAMS, FRCP1, Wesley Yeung, MBBS2 and Yee Sin Leo, MPH, FAMS, FRCP1, (1)Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore, (2)Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore


D. Lye, None

W. Yeung, None

Y. S. Leo, None

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