摘要
背景 登革熱是南台灣重要的蚊媒傳染病，近期爆發的兩次大流行總共造成數百人死亡，本研究試圖了解患者共病症與死亡的關聯。 方法 本研究由衛生福利部資料科學中心兩百萬抽樣歸人檔，擷取2011至2015年之間感染登革熱的病患，分析其性別、年齡、過去是否曾感染登熱，以及共病症的病史，探討感染後90天內全死因死亡率，並以多元邏輯斯迴歸分析模型，尋找重要的影響因子。 結果 抽樣檔於2011至2015之間，共計6166名登革熱病患，死亡人數為42(0.68%)人。死亡組以老人29(69.05%)名最多，多元邏輯斯迴歸分析模型顯示，年齡(OR=1.06，95% CI 1.04-1.09，p < 0.0001)、鬱血性心衰竭(OR=6.22，95% CI 2.75-14.04，p < 0.0001)、消化性潰瘍(OR=3.05，95% CI 1.57-5.92，p = 0.0001)、有其他併發症之糖尿病(OR=2.52，95% CI 1.32-4.81，p = 0.0041)對死亡之勝算比達統計顯著。所有顯著因子之ROC曲線分析，曲線下面積為0.871。 討論 本研究分析之登革熱死亡危險因子，可提供臨床上判斷病人預後的參考依據。
並列摘要
Background Dengue fever is an important mosquito-borne disease in Taiwan. Two recent pandemic outbreaks caused hundreds of deaths respectively. This study investigated the association between the comorbidities and mortality of dengue patients. Material and methods Dengue patients between 2011 and 2015 were included from two million samples of the health-related database. All-cause mortality within 90 days after the dengue infection was the outcome of interest. Gender, age, previous dengue infection, and comorbidities were the covariates putting into the multivariable logistic regression model. Results A total of 6166 dengue fever patients with 42 (0.68%) deaths were found. Most (n=29, 69.05%) of the patients in the non-survival group were above 65 years old. The multivariable logistic regression analysis showed age (OR=1.06，95% CI 1.04-1.09，p < 0.0001)、congestive heart failure (OR=6.22，95% CI 2.75-14.04，p < 0.0001)、peptic ulcer disease (OR=3.05，95% CI 1.57-5.92，p = 0.0001)、diabetes with other complications (OR=2.52，95% CI 1.32-4.81，p = 0.0041) had statistically significant odds ratio of death. ROC curve of the model revealed the area under the curve was 0.871. Discussion The risk factors found in this study may help the clinicians get a better understanding of the prognosis in dengue patients.