Division of Infectious Disease, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.
PLoS Negl Trop Dis. 2024 Jun 14;18(6):e0012253. doi: 10.1371/journal.pntd.0012253. eCollection 2024 Jun.
The long-term mortality and morbidity of patients with severe fever with thrombocytopenia syndrome (SFTS) remain unclear.
This retrospective cohort study was conducted using the National Health Insurance Service dataset on hospitalized patients with SFTS aged ≥20 years between 2016 and 2021 (n = 1,217). Each SFTS case was matched with three controls hospitalized for non-SFTS-related diseases using propensity score matching. The all-cause mortality of patients with SFTS was evaluated during the one-year follow-up and compared with that of controls. Post-discharge events were investigated to determine the effects of SFTS on post-acute sequelae.
Finally, 1,105 patients with SFTS and 3,315 controls were included. Patients with SFTS had a higher risk of death during the one-year follow-up than that of controls (hazard ratio [HR], 2·26; 95% confidence interval [CI], 1·82-2·81). Thirty-day mortality was significantly higher in the SFTS group (HR, 3·99; 95% CI, 3·07-5·19) than in the control group. An increased risk of death after 31-365 days was observed among controls, though this difference was significant only among patients in their 80s (HR, 0·18; 95% CI, 0·06-0·57). For post-discharge events, patients in the SFTS group exhibited a higher risk of readmission (HR, 1·17; 95% CI, 1·04-1·32) and emergency room visit (HR, 2·32; 95% CI, 1·96-2·76) than those in the control group.
SFTS induces a higher risk of short-term mortality and post-acute sequelae in hospitalized patients during a one-year follow-up than non-SFTS-related diseases. Our results provide guidance for the management of SFTS.
严重发热伴血小板减少综合征(SFTS)患者的长期死亡率和发病率仍不清楚。
本回顾性队列研究使用 2016 年至 2021 年期间国家健康保险服务数据集,对年龄≥20 岁的住院 SFTS 患者(n=1217)进行了研究。使用倾向评分匹配,将每个 SFTS 病例与因非 SFTS 相关疾病住院的 3 名对照进行匹配。在一年的随访期间,评估 SFTS 患者的全因死亡率,并与对照组进行比较。调查出院后事件,以确定 SFTS 对急性后后遗症的影响。
最终,共纳入 1105 例 SFTS 患者和 3315 例对照。SFTS 患者在一年随访期间的死亡风险高于对照组(风险比[HR],2.26;95%置信区间[CI],1.82-2.81)。SFTS 组的 30 天死亡率显著高于对照组(HR,3.99;95%CI,3.07-5.19)。在对照组中,31-365 天后死亡风险增加,但仅在 80 岁以上的患者中这一差异具有统计学意义(HR,0.18;95%CI,0.06-0.57)。在出院后事件方面,SFTS 组患者再入院(HR,1.17;95%CI,1.04-1.32)和急诊就诊(HR,2.32;95%CI,1.96-2.76)的风险高于对照组。
在一年的随访期间,SFTS 导致住院患者的短期死亡率和急性后后遗症的风险高于非 SFTS 相关疾病。我们的研究结果为 SFTS 的管理提供了指导。