Hitit University School of Medicine, Department of Medical Biochemistry, Corum, Turkey.
Hitit University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Corum, Turkey.
Ticks Tick Borne Dis. 2019 Aug;10(5):1035-1040. doi: 10.1016/j.ttbdis.2019.05.010. Epub 2019 May 28.
Crimean-Congo hemorrhagic fever (CCHF) is fatal. Therefore, it is very important to use an inexpensive, easily accessible, quick and accurate screening index based on clinical signs and laboratory parameters to identify patients suspected of having CCHF. Laboratory test results on the day of hospitalization for 268 inpatients suspected of having CCHF were used to calculate the laboratory section of the Hitit Index, while 65 of these were also monitored daily during their hospital stay to develop the clinical section of the Hitit Index. Two-hundred CCHF-negative outpatients were also evaluated. One-hundred and forty-nine inpatients were CCHF-positive and 119 inpatients were CCHF-negative. The Hitit Index is 5.6 - (5.3lymphocyte) - (0.02fibrinogen) - (12direct bilirubin) + (0.04AST) + (0.32hematocrit) - (0.5neutrophil) - (0.07CKD-EPI) - (0.001CK) ± conjunctival hyperemia (+1.5 in conjunctival hyperemia presence and -1.5 in conjunctival hyperemia absence). In 65 inpatients monitored daily, Hitit Index results for CCHF-positive and negative inpatients were 6.10(1.90-12.30) and -5.35(-8.83- -1.95), while CCHF-negative outpatients were -10.99(-15.64- -6.95) (P < 0.001), respectively. On hospitalization day, just one inpatient was false-negative in 27 CCHF-positive inpatients, while four were false-positive among 38 CCHF-negative inpatients using the Hitit Index. After 24 h, just one inpatient was diagnosed falsely among 27 CCHF-positive and 38 CCHF-negative inpatients, and there was no change after 48 h. Management of patients living in endemic regions suspected of having CCHF could be achieved within minutes using the Hitit Index. Patients with Hitit Index less than zero can be monitored as outpatients, while patients with Hitit Index results above zero must be hospitalized in infectious diseases wards. This study was not registered since it was retrospective.
克里米亚-刚果出血热（CCHF）是致命的。因此，使用一种基于临床症状和实验室参数的廉价、易于获取、快速且准确的筛选指标来识别疑似患有 CCHF 的患者非常重要。对 268 名疑似患有 CCHF 的住院患者的住院当天的实验室检查结果进行了计算，同时对其中的 65 名患者在住院期间进行了每日监测，以开发 Hitit 指数的临床部分。还评估了 200 名 CCHF 阴性门诊患者。149 名住院患者 CCHF 阳性，119 名住院患者 CCHF 阴性。Hitit 指数为 5.6 - (5.3淋巴细胞) - (0.02纤维蛋白原) - (12直接胆红素) + (0.04AST) + (0.32红细胞压积) - (0.5中性粒细胞) - (0.07CKD-EPI) - (0.001CK) ± 结膜充血 (+1.5 在结膜充血存在时，-1.5 在结膜充血不存在时)。在对 65 名每日监测的住院患者中，CCHF 阳性和阴性住院患者的 Hitit 指数结果分别为 6.10(1.90-12.30)和-5.35(-8.83- -1.95)，而 CCHF 阴性门诊患者为-10.99(-15.64- -6.95)(P<0.001)。在住院当天，27 名 CCHF 阳性住院患者中只有 1 名患者的检测结果为假阴性，而在 38 名 CCHF 阴性住院患者中，有 4 名患者的检测结果为假阳性。24 小时后，27 名 CCHF 阳性和 38 名 CCHF 阴性住院患者中只有 1 名患者的诊断结果有误，48 小时后无变化。使用 Hitit 指数可以在几分钟内对居住在流行地区的疑似患有 CCHF 的患者进行管理。Hitit 指数小于零的患者可以作为门诊患者进行监测，而 Hitit 指数结果大于零的患者必须住院接受传染病病房治疗。由于这是一项回顾性研究，因此本研究未进行注册。
