Wang Li, Zou Zhiqiang, Hou Chunguo, Liu Xiangzhong, Jiang Fen, Yu Hong
Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China.
BMC Infect Dis. 2017 Jan 7;17(1):42. doi: 10.1186/s12879-016-2111-0.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging epidemic infectious disease with high mortality in East Aisa, especially in China. To predict the prognosis of SFTS precisely is important in clinical practice.
From May 2013 to November 2015, 233 suspected SFTS patients were tested for SFTS virus using RT-PCR. Cox regression model was utilized to comfirm independent risk factors for mortality. A risk score model for mortality was constructed based on regression coefficient of risk factors. Log-rank test was used to evaluate the significance of this model.
One hundred seventy-four patients were confirmed with SFTS, of which 40 patients died (23%). Baseline age, serum aspartate aminotransferase (AST) and serum creatinine (sCr) level were independent risk factors of mortality. The area under ROC curve (AUCs) of these parameters for predicting death were 0.771, 0.797 and 0.764, respectively. And hazard ratio (HR) were 1.128, 1.002 and 1.013, respectively. The cutoff value of the risk model was 10. AUC of the model for predicting mortality was 0.892, with sensitivity and specificity of 82.5 and 86.6%, respectively. Log-rank test indicated strong statistical significance (× = 88.35, p < 0.001).
This risk score model may be helpful to predicting the prognosis of SFTS patients.
发热伴血小板减少综合征(SFTS)是东亚地区一种新出现的具有高死亡率的流行性传染病,在中国尤为如此。在临床实践中,准确预测SFTS的预后很重要。
2013年5月至2015年11月,采用逆转录聚合酶链反应(RT-PCR)对233例疑似SFTS患者进行SFTS病毒检测。利用Cox回归模型确定死亡的独立危险因素。基于危险因素的回归系数构建死亡风险评分模型。采用对数秩检验评估该模型的显著性。
174例患者确诊为SFTS,其中40例死亡(23%)。基线年龄、血清天冬氨酸转氨酶(AST)和血清肌酐(sCr)水平是死亡的独立危险因素。这些参数预测死亡的ROC曲线下面积(AUCs)分别为0.771、0.797和0.764。危险比(HR)分别为1.128、1.002和1.013。风险模型的截断值为10。该模型预测死亡率的AUC为0.892,敏感性和特异性分别为82.5%和86.6%。对数秩检验显示有很强的统计学意义(χ² = 88.35,p < 0.001)。
该风险评分模型可能有助于预测SFTS患者的预后。