PDF(Pubmed)
Abstract：
BACKGROUND: Identification of pleural effusion (PE) in dengue infection is an objective measure of plasma leakage and may predict disease progression. However, no studies have systematically assessed the frequency of PE in patients with dengue, and whether this differs across age and imaging modality.
METHODS: We searched Pubmed, Embase Web of Science and Lilacs (period 1900-2021) for studies reporting on PE in dengue patients (hospitalized and outpatient). We defined PE as fluid in the thoracic cavity detected by any imaging test. The study was registered in PROSPERO (CRD42021228862). Complicated dengue was defined as hemorrhagic fever, dengue shock syndrome or severe dengue.
RESULTS: The search identified 2,157 studies of which 85 studies were eligible for inclusion. The studies (n = 31 children, n = 10 adults, n = 44 mixed age) involved 12,800 patients (30% complicated dengue). The overall frequency of PE was 33% [95%CI: 29 to 37%] and the rate of PE increased significantly with disease severity (P = 0.001) such that in complicated vs. uncomplicated dengue the frequencies were 48% and 17% (P < 0.001). When assessing all studies, PE occurred significantly more often in children compared to adults (43% vs. 13%, P = 0.002) and lung ultrasound more frequently detected PE than conventional chest X-ray (P = 0.023).
CONCLUSIONS: We found that 1/3 of dengue patients presented with PE and the frequency increased with severity and younger age. Importantly, lung ultrasound demonstrated the highest rate of detection. Our findings suggest that PE is a relatively common finding in dengue and that bedside imaging tools, such as lung ultrasound, potentially may enhance detection.
METHODS: We searched Pubmed, Embase Web of Science and Lilacs (period 1900-2021) for studies reporting on PE in dengue patients (hospitalized and outpatient). We defined PE as fluid in the thoracic cavity detected by any imaging test. The study was registered in PROSPERO (CRD42021228862). Complicated dengue was defined as hemorrhagic fever, dengue shock syndrome or severe dengue.
RESULTS: The search identified 2,157 studies of which 85 studies were eligible for inclusion. The studies (n = 31 children, n = 10 adults, n = 44 mixed age) involved 12,800 patients (30% complicated dengue). The overall frequency of PE was 33% [95%CI: 29 to 37%] and the rate of PE increased significantly with disease severity (P = 0.001) such that in complicated vs. uncomplicated dengue the frequencies were 48% and 17% (P < 0.001). When assessing all studies, PE occurred significantly more often in children compared to adults (43% vs. 13%, P = 0.002) and lung ultrasound more frequently detected PE than conventional chest X-ray (P = 0.023).
CONCLUSIONS: We found that 1/3 of dengue patients presented with PE and the frequency increased with severity and younger age. Importantly, lung ultrasound demonstrated the highest rate of detection. Our findings suggest that PE is a relatively common finding in dengue and that bedside imaging tools, such as lung ultrasound, potentially may enhance detection.
摘要：
背景：登革热感染中胸腔积液（PE）的鉴定是血浆渗漏的客观指标，可以预测疾病进展。然而,没有研究系统地评估登革热患者的PE频率，以及这是否因年龄和成像方式而异。
方法：我们搜索了Pubmed，EmbaseWebofScience和Lilacs（1900-2021年），用于报道登革热患者（住院和门诊）的PE研究。我们将PE定义为通过任何成像测试检测到的胸腔中的液体。该研究在PROSPERO（CRD42021228862）中注册。复杂的登革热被定义为出血热，登革热休克综合征或严重登革热。
结果：检索确定了2,157项研究，其中85项研究符合纳入条件。研究(n=31名儿童，n=10个成年人，n=44混合年龄）涉及12,800名患者（30％复杂登革热）。PE的总体频率为33％[95CI：29至37％]，并且PE的发生率随疾病严重程度而显着增加（P=0.001），因此在复杂的vs.无并发症的登革热发生率分别为48%和17%(P<0.001)。在评估所有研究时，与成人相比，儿童发生PE的频率明显更高(43%vs.13%,P=0.002），并且肺部超声检查比常规胸部X线更频繁地检测到PE（P=0.023）。
结论：我们发现1/3的登革热患者出现PE，并且频率随严重程度和年龄的增加而增加。重要的是,肺部超声显示检出率最高。我们的研究结果表明，PE是登革热中相对常见的发现，床边成像工具，比如肺部超声，可能会增强检测。
方法：我们搜索了Pubmed，EmbaseWebofScience和Lilacs（1900-2021年），用于报道登革热患者（住院和门诊）的PE研究。我们将PE定义为通过任何成像测试检测到的胸腔中的液体。该研究在PROSPERO（CRD42021228862）中注册。复杂的登革热被定义为出血热，登革热休克综合征或严重登革热。
结果：检索确定了2,157项研究，其中85项研究符合纳入条件。研究(n=31名儿童，n=10个成年人，n=44混合年龄）涉及12,800名患者（30％复杂登革热）。PE的总体频率为33％[95CI：29至37％]，并且PE的发生率随疾病严重程度而显着增加（P=0.001），因此在复杂的vs.无并发症的登革热发生率分别为48%和17%(P<0.001)。在评估所有研究时，与成人相比，儿童发生PE的频率明显更高(43%vs.13%,P=0.002），并且肺部超声检查比常规胸部X线更频繁地检测到PE（P=0.023）。
结论：我们发现1/3的登革热患者出现PE，并且频率随严重程度和年龄的增加而增加。重要的是,肺部超声显示检出率最高。我们的研究结果表明，PE是登革热中相对常见的发现，床边成像工具，比如肺部超声，可能会增强检测。
