Tekin Yusuf Kenan, Engin Aynur
Department of Emergency Medicine, Sivas Cumhuriyet University Medical Faculty, Sivas, Turkey.
Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University Medical Faculty, Sivas, Turkey.
Rambam Maimonides Med J. 2020 Oct 14;11(4):e0032. doi: 10.5041/RMMJ.10393.
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease with a high mortality rate. Although CCHF has been widely investigated over the past decade, a review of the literature indicated no data on the prognostic capacity of the mean platelet volume-to-platelet count ratio (MPVPCR) and the red cell distribution width-to-platelet count ratio (RDWPCR) for the systemic inflammatory response in patients with CCHF. This study aimed to evaluate the prognostic ability of MPVPCR and RDWPCR on mortality in patients with CCHF.
A total of 807 patients that were admitted to the Cumhuriyet University Hospital's Emergency Department from January 2010 to December 2018 were involved. The RDWPCR and MPVPCR were separately calculated via absolute blood red cell and platelet counts at the time of admission. Before performing receiver-operating characteristic (ROC) curve analysis to define the optimum cut-off values of MPVPCR and RDWPCR stepwise logistic regression analysis was used to determine the predictive factors related to mortality in CCHF patients.
Values of both MPVPCR and RDWPCR were significantly lower in survivors than in non-survivors (MPVPCR: 0.20±0.23 versus 0.55±0.55, P<0.001; RDWPCR: 0.27±0.32 versus 0.77±0.77, P<0.001, respectively). The MPVPCR (odds ratio [OR], 5.95; P=0.048) was an independent predictor for the prognosis of mortality in CCHF patients. The area under the curve in the ROC curve analysis for MPVPCR was 0.876 with a cut-off of 0.21 (sensitivity 87%, specificity 76%).
At the time of admission, MPVPCR might be a useful predictor of mortality in patients with CCHF.
克里米亚-刚果出血热（CCHF）是一种由蜱传播的病毒性疾病，死亡率很高。尽管在过去十年中对CCHF进行了广泛研究，但文献综述表明，尚无关于平均血小板体积与血小板计数比值（MPVPCR）和红细胞分布宽度与血小板计数比值（RDWPCR）对CCHF患者全身炎症反应的预后能力的数据。本研究旨在评估MPVPCR和RDWPCR对CCHF患者死亡率的预后能力。
纳入2010年1月至2018年12月在Cumhuriyet大学医院急诊科收治的807例患者。入院时通过绝对红细胞和血小板计数分别计算RDWPCR和MPVPCR。在进行受试者工作特征（ROC）曲线分析以确定MPVPCR和RDWPCR的最佳临界值之前，采用逐步逻辑回归分析来确定与CCHF患者死亡率相关的预测因素。
幸存者的MPVPCR和RDWPCR值均显著低于非幸存者（MPVPCR：0.20±0.23对0.55±0.55，P<0.001；RDWPCR：0.27±0.32对0.77±0.77，P<0.001）。MPVPCR（比值比[OR]，5.95；P=0.048）是CCHF患者死亡率预后的独立预测因素。MPVPCR的ROC曲线分析中曲线下面积为0.876，临界值为0.21（敏感性87%，特异性76%）。
入院时，MPVPCR可能是CCHF患者死亡率的有用预测指标。
