To Determine the Association of Acute Febrile Illness with MODS in Terms Of Clinical Features, Etiology and Outcome
Authors/Creators
- 1. Senior Resident, Dept of General Medicine, HBTMC & Dr R N Cooper Hospital, Juhu, Mumbai
- 2. Associate Professor, Dept of General Medicine, HBTMC & Dr R N Cooper Hospital, Juhu, Mumbai
- 3. Professor, Dept of General Medicine, HBTMC & Dr R N Cooper Hospital, Juhu, Mumbai
Description
Background: Multiple organ failure (MOF) is a clinical syndrome that came to prominence in the 1970s.1 Its conception resulted from reports in the late 1960s which described remote organ failure, such as pulmonary and liver failure, as a consequence of severe sepsis. As there were limited studies on acute febrile illness and its association with MODS, we conducted this study in order of clinical features, etiology and outcome of MODS in patients with acute febrile illness. Material and Methods: A Hospital based prospective Observational study was conducted at Department of Medicine, tertiary care public hospital for period one year after Ethics committee permission. Total 100 patients were enrolled after matching inclusion and exclusion criteria. Results: 16 to 25 years (46%) was the most common age group amongst study population with male predominance (81%). Fever (100%) was the most frequent Clinical features followed by Chills/Rigors (98%). Bleeding Manifestations was present in 19% of study population. Deranged creatinine was present in 29% of study population .Vivax Malaria (26%) was the most common Peripheral smear findings amongst study population followed by Falciparum Malaria (1%) and Mixed malaria (1%). INR was Deranged in 36 % of study population. On USG Abdomen/Pelvis, Hepatomegaly (17%) was the most frequent findings. Dengue (53%) was the most common cause of thrombocytopenia amongst study population followed by Malaria (27%), Leptospirosis (13%), Septicemia (4%), Enteric fever (3%). Blood Transfusion was given in 16% of study population. RDP, FFP, PCV and SDP were Blood Product Transfused amongst which RDP was the most common. 94% of the study population had Less than 10 days of hospital stay. 89% of the study population were alive while death was occurred in 11% of study population. Death occurred most commonly in Dengue (36.40%) and Leptospirosis (36.40%) each and septicemia (27.30%). The common causes of death were Dengue Hemorrhagic Fever, Leptospirosis with ARDS and septicemia with shock. Blood system (31%) was the most common system in MODS followed by kidney(30%), lungs (13%), liver (12%) and CNS (5%). Mortality was observed most commonly in patients with more than 3 organ involvement (54.5%) followed by three organ (36.4%) and two organ (9.1%). Conclusions: Most common etiology of MODS was Dengue and Leptospirosis and septicemia. Hematological system was the most common system in MODS followed by kidney, lungs, liver and CNS. Mortality in was observed most commonly in patients with more than 3 organ involvement followed by three organ and two organ. It was observed that as the number of organ involvement increases in MODS, the risk of mortality also increases.
Abstract (English)
Background: Multiple organ failure (MOF) is a clinical syndrome that came to prominence in the 1970s.1 Its conception resulted from reports in the late 1960s which described remote organ failure, such as pulmonary and liver failure, as a consequence of severe sepsis. As there were limited studies on acute febrile illness and its association with MODS, we conducted this study in order of clinical features, etiology and outcome of MODS in patients with acute febrile illness. Material and Methods: A Hospital based prospective Observational study was conducted at Department of Medicine, tertiary care public hospital for period one year after Ethics committee permission. Total 100 patients were enrolled after matching inclusion and exclusion criteria. Results: 16 to 25 years (46%) was the most common age group amongst study population with male predominance (81%). Fever (100%) was the most frequent Clinical features followed by Chills/Rigors (98%). Bleeding Manifestations was present in 19% of study population. Deranged creatinine was present in 29% of study population .Vivax Malaria (26%) was the most common Peripheral smear findings amongst study population followed by Falciparum Malaria (1%) and Mixed malaria (1%). INR was Deranged in 36 % of study population. On USG Abdomen/Pelvis, Hepatomegaly (17%) was the most frequent findings. Dengue (53%) was the most common cause of thrombocytopenia amongst study population followed by Malaria (27%), Leptospirosis (13%), Septicemia (4%), Enteric fever (3%). Blood Transfusion was given in 16% of study population. RDP, FFP, PCV and SDP were Blood Product Transfused amongst which RDP was the most common. 94% of the study population had Less than 10 days of hospital stay. 89% of the study population were alive while death was occurred in 11% of study population. Death occurred most commonly in Dengue (36.40%) and Leptospirosis (36.40%) each and septicemia (27.30%). The common causes of death were Dengue Hemorrhagic Fever, Leptospirosis with ARDS and septicemia with shock. Blood system (31%) was the most common system in MODS followed by kidney(30%), lungs (13%), liver (12%) and CNS (5%). Mortality was observed most commonly in patients with more than 3 organ involvement (54.5%) followed by three organ (36.4%) and two organ (9.1%). Conclusions: Most common etiology of MODS was Dengue and Leptospirosis and septicemia. Hematological system was the most common system in MODS followed by kidney, lungs, liver and CNS. Mortality in was observed most commonly in patients with more than 3 organ involvement followed by three organ and two organ. It was observed that as the number of organ involvement increases in MODS, the risk of mortality also increases.
Files
IJPCR,Vol16,Issue5,Article165.pdf
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Additional details
Dates
- Accepted
-
2024-04-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue5,Article165.pdf
- Development Status
- Active
References
- 1. Baue AE. Multiple, progressive or sequential system failure: a syndrome for the 1970s. Arch Surg. 1975; 110: 779-781. 2. Linda S. Field, Deepak Kamet. Fever. In: Kingman RM, Stanton BF, St Game III JW, Schurz.Nelson Textbook of Pediatrics. 20th Edition. Elsevier; Philadelphia; 2016.176.127. 3. Marshall JC. Inflammation, coagulopathy, and the pathogenesis of multiple organ dysfunction syndromes. Crit Care Med. 2001; 29 (7 Suppl): S99-S106. 4. Yasmeen Khatib, Dr. Vaishali Jain, Dr. Richa Patel, One year study of thrombocytopenia in a peripheral hospital of Mumbai, Volume 6, Issue 4 (April 2016), PP. 26-30 5. Smita Surendra. Masamatti et al., Laboratory and Etiological Profile of Febrile Thrombocytopenia Cases, National Journal of Laboratory Medicine. 2016 Jul; 5(3): PO44-PO48. 6. Shah HR, Vaghani BD, Gohel P, Virani BK. Clinical profile review of patients with thrombocytopenia: A study of 100 cases at a tertiary care centre. Int J Cur Res Rev. 2015; 7 (6):33- 37. 7. Jawed Ahmed Badvi, Bahawaluddin Jamro, Aftab Ahmed Soomro, Shankar lal,Saifullah Jamro. An experience of thrombocytopenia in children at tertiary care hospitals sukkur and larkana MC. 2012; 19:23-26. 8. Kuhne T, Berchtold W, Michaels LA, Wu R, Donato H et al. Newly diagnosed immune thrombocytopenia in children and adults: a comparative prospective observational registry of the International Cooperative Immune Thrombocytopenia Study group. Haematologica J. 2011; 96:1831-1837. 9. Ansari S, Khoharo HK, Abro A, Akhund IA, Qureshi F. Thrombocytopenia in plasmodium malaria. J Ayub Med Coll Abbottabad. 2009; 21: 145-147. 10. Kibria SG, Islam MDU, Chowdhury AJ, Ali MY, Haque MR, Mustanzid SM, Ali SY. Prevalence of hematological disorder; A bone marrow study of 177 cases in a private hospital at Faridpur. Faridpur Med Coll J. 2010; 5:11-13. 11. Shelke YP, Deotale VS, Maraskolhe DL. Spectrum of infections in acute febrile illness in central India. Indian J Med Microbiol. 2017; 35:480-4 12. GuruprasadaShetty et al., Thrombocytopenia in children with malaria–A study from coastal Karnataka, India, Asian Pacific Journal of Tropical Disease. April 2012;2(2): 107-109. 13. Naveen Kulkarni et al / A clinical study of febrile thrombocytopenia at a Tertiary Care Hospital in North Karnataka, IJBR (2017) 08 (01) 14. Shubhankar Mishra, Ramya Ramanathan, and Sunil Kumar Agarwalla, Clinical Profile of Dengue Fever in Children: A Study from Southern Odisha, India,Scientifica (Cairo). 2016; 2016: 6391594. 15. Bhardwaj LM, Borthakur S, Bhattacharyya PC. Clinico-epidemiological study of dengue cases in a tertiary care hospital, Guwahati, Assam. Int J Adv Med. 2017; 4:1605-12. 16. Vishal Yadav, Abhishek Singhai, Study of febrile thrombocytopenia in Malwa region of India Asian Journal of Medical Sciences. Sep-Oct 2017; 8(5):83-87 17. 17. Sumangala S, Biradar S, Ali MZ, Saudagar M. A study of clinical and laboratory evaluation and outcome of patients with acute febrile illness with thrombocytopenia. APIK J Int Med. 2020; 8:121-7. 18. Stasi R, Provan D. Management of immune thrombocytopenic purpura in adults. Mayo Clin Proc. 2004; 79:504-22. 19. Anubha Sharma et al., A prospective observational study of thrombocytopenia in high-risk neonates in a tertiary care teaching hospital, Sri Lanka Journal of Child Health, 2015: 44(4): 213-219 20. Patil P, Solanke P, Harshe G. To Study Clinical Evaluation and outcome of Patients with Febrile Thrombocytopenia. IJSAR. 2014; 4(10): 1-3. 21. Kumar P, Chandra K. A Clinical study of febrile thrombocytopenia: A hospital-based retrospective study. Indian Journal of Clinical Practice. 2014;24(10):952-957 22. Modi T et al: Clinical Profile of Febrile Thrombocytopenia, Journal of Research in Medical and Dental Science, 2016; 4(2). 23. Bhanukumar MuthaIah et al., Study of Aetiology and Outcome in Acute Febrile Illness Patients with Multiple Organ Dysfunction Syndrome, Journal of Clinical and Diagnostic Research. 2016 Aug, Vol-10(8): OC16-OC18 24. Dash L, Singh LK, Murmu M, Susruth KP, Kerketta A, Hiregoudar MB. Clinical profile and outcome of organ dysfunction in sepsis. Int J Res Med Sci. 2018; 6:1927-33. 25. Bhattacharya PK, Gautom D, Nath N, Saikia H. A comparative Study to Assess the Determinants and outcomes of Sepsis Treated in Medical Wards and ICU in an Indian Teaching Hospital. J Clin Diagn Res. 2016 Jun; 10(6): OC01- 6.