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韩国住院患者(2018 - 2022年)中与严重发热伴血小板减少综合征死亡相关的危险因素

Risk factors associated with death due to severe fever with thrombocytopenia syndrome in hospitalized Korean patients (2018-2022).

作者信息

Kim Jia, Hong Hyo-Jeong, Hwang Ji-Hye, Shin Na-Ri, Hwang Kyungwon

机构信息

Division of Zoonotic and Vector Borne Disease Control, Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency, Cheong, Republic of Korea.

出版信息

Osong Public Health Res Perspect. 2023 Jun;14(3):151-163. doi: 10.24171/j.phrp.2023.0048. Epub 2023 Jun 8.

Abstract

BACKGROUND

Severe fever with thrombocytopenia syndrome (SFTS) has no vaccine or treatment and an extremely high fatality rate. We aimed to analyze and evaluate the risk factors for death associated with SFTS.

METHODS

Among reports from 2018 to 2022, we compared and analyzed 1,034 inpatients aged 18 years or older with laboratory-confirmed SFTS who underwent complete epidemiological investigations.

RESULTS

Most of the inpatients with SFTS were aged 50 years or older (average age, 67.6 years). The median time from symptom onset to death was 9 days, and the average case fatality rate was 18.5%. Risk factors for death included age of 70 years or older (odds ratio [OR], 4.82); agriculture-related occupation (OR, 2.01); underlying disease (OR, 7.20); delayed diagnosis (OR, 1.28 per day); decreased level of consciousness (OR, 5.53); fever/chills (OR, 20.52); prolonged activated partial thromboplastin time (OR, 4.19); and elevated levels of aspartate aminotransferase (OR, 2.91), blood urea nitrogen (OR, 2.62), and creatine (OR, 3.21).

CONCLUSION

The risk factors for death in patients with SFTS were old age; agriculture-related occupation; underlying disease; delayed clinical suspicion; fever/chills; decreased level of consciousness; and elevated activated partial thromboplastin time, aspartate aminotransferase, blood urea nitrogen, and creatine levels.

摘要

背景

发热伴血小板减少综合征(SFTS)尚无疫苗或治疗方法,病死率极高。我们旨在分析和评估与SFTS相关的死亡危险因素。

方法

在2018年至2022年的报告中,我们对1034例年龄在18岁及以上、经实验室确诊且接受了完整流行病学调查的SFTS住院患者进行了比较和分析。

结果

大多数SFTS住院患者年龄在50岁及以上(平均年龄67.6岁)。从症状出现到死亡的中位时间为9天,平均病死率为18.5%。死亡危险因素包括70岁及以上年龄(比值比[OR],4.82);与农业相关的职业(OR,2.01);基础疾病(OR,7.20);诊断延迟(每天OR,1.28);意识水平下降(OR,5.53);发热/寒战(OR,20.52);活化部分凝血活酶时间延长(OR,4.19);以及天冬氨酸转氨酶(OR,2.91)、血尿素氮(OR,2.62)和肌酐(OR,3.21)水平升高。

结论

SFTS患者的死亡危险因素为高龄;与农业相关的职业;基础疾病;临床怀疑延迟;发热/寒战;意识水平下降;以及活化部分凝血活酶时间、天冬氨酸转氨酶、血尿素氮和肌酐水平升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c0/10522827/416156b3c6f2/j-phrp-2023-0048f1.jpg

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