Department of Infectious Diseases, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Wenhua Xi Road 107, Jinan, 250012, Shandong, China.
Department of Rheumatology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Wenhua Xi Road 107, Jinan, 250012, Shandong, China.
Eur J Clin Microbiol Infect Dis. 2022 Dec;41(12):1415-1420. doi: 10.1007/s10096-022-04506-4. Epub 2022 Oct 11.
To better understand the progression of severe fever with thrombocytopenia syndrome (SFTS), identify early predictors of mortality, and improve the cure rate, the present study aimed to analyze the demographic feature, clinical characteristics, and laboratory parameters of patients with SFTS and to explore the risk factors associated with fatal outcome. We retrospectively analyzed demographic feature, clinical characteristics, and laboratory parameters of 216 laboratory-confirmed SFTS patients in Shandong province between January 2015 and December 2019. Univariate analysis was used to assess the relevance between these factors and fatal outcome. Factors with P < 0.05 in univariate analysis were further analyzed using multivariable logistic regression analysis to identify the independent risk factors for mortality of SFTS. Age, five complications (including CNS symptoms, pulmonary infection, heart failure, arrhythmia, and bleeding events), and ten abnormal laboratory parameters (including serum viral load, blood platelet, ALT, AST, LDH, CK, CK-MB, Cr, serum Ca, and APTT) were statistically significant by univariate analysis. These factors were further analyzed by multivariable logistic regression analysis, and the results indicated that coma, pulmonary infection, high viral load, and prolonged APTT were associated with fatal outcome in SFTS patients. Our study identified four independent risk factors associated with fatal outcome for SFTS patients. The results were hoped to provide help for active treatment of SFTS. However, the identification of risk factors is not absolutely associated with fatal outcome. Patients' risk should be assessed by dynamic observation of the changes in risk factor indicators.
为了更好地了解严重发热伴血小板减少综合征（SFTS）的进展，确定死亡的早期预测因素，并提高治愈率，本研究旨在分析 SFTS 患者的人口统计学特征、临床特征和实验室参数，并探讨与致命结局相关的危险因素。我们回顾性分析了 2015 年 1 月至 2019 年 12 月山东省 216 例实验室确诊的 SFTS 患者的人口统计学特征、临床特征和实验室参数。采用单因素分析评估这些因素与致命结局的相关性。单因素分析中 P<0.05 的因素进一步采用多因素 logistic 回归分析，以确定 SFTS 患者死亡的独立危险因素。年龄、五种并发症（包括 CNS 症状、肺部感染、心力衰竭、心律失常和出血事件）和十种异常实验室参数（包括血清病毒载量、血小板、ALT、AST、LDH、CK、CK-MB、Cr、血清 Ca 和 APTT）在单因素分析中具有统计学意义。这些因素进一步通过多因素 logistic 回归分析进行分析，结果表明，昏迷、肺部感染、高病毒载量和 APTT 延长与 SFTS 患者的致命结局相关。本研究确定了与 SFTS 患者致命结局相关的四个独立危险因素。结果希望为 SFTS 的积极治疗提供帮助。然而，危险因素的识别并不绝对与致命结局相关。应通过动态观察危险因素指标的变化来评估患者的风险。
