Department of Respiratory and Critical Care Medicine, The Second People's Hospital of Hefei, Bengbu Medical University, Hefei, 230011, Anhui, China.
Department of Respiratory and Critical Care Medicine, The Second People's Hospital of Hefei, Hefei, 230011, Anhui, China.
BMC Infect Dis. 2024 Aug 1;24(1):765. doi: 10.1186/s12879-024-09599-0.
Since its discovery, severe fever with thrombocytopenia syndrome (SFTS) has been characterized by rapid progression and poor prognosis, and no specific treatment is available. The aim of this study was to investigate the early warning indicators of mortality in SFTS patients.
This is a retrospective cross-sectional study. The study subjects were patients who were admitted to the hospital with a confirmed diagnosis of SFTS from January 2023 to October 2023, and their clinical symptoms and signs at the time of admission, as well as the laboratory indexes of the first blood collection after admission were collected, grouped according to the prognosis, and statistically analyzed.
A total of 141 patients were collected, of which 27 patients died and 114 patients were in the survival group. Through statistical analysis, patients with combined hemorrhagic manifestations, disturbance of consciousness, lymphopenia, elevated lipase, and prolonged thrombin time on admission were independent risk factors for patients' death. By plotting the working characteristic curve of the subjects, as well as calculating the area under the curve, the results showed that the AUC of lymphopenia count was 0.670, 95% CI (0.563-0.776), P = 0.006; the AUC of elevated serum lipase index was 0.789, 95% CI (0.699-0.878), p < 0.001; the AUC of prolonged thrombin time was 0.749, 95% CI (0.645-0.854), p < 0.001.
Patients with hemorrhagic manifestations, disturbance of consciousness, lymphocyte reduction, elevated serum lipase, and prolonged thrombin time on admission are more worthy of the clinician's attention, and require early and effective interventions to avoid further disease progression.
自发现以来，严重发热伴血小板减少综合征（SFTS）以快速进展和预后不良为特征，且尚无特效治疗方法。本研究旨在探讨 SFTS 患者死亡的早期预警指标。
这是一项回顾性横断面研究。研究对象为 2023 年 1 月至 2023 年 10 月因确诊 SFTS 住院的患者，收集其入院时的临床症状和体征以及入院后首次采血的实验室指标，根据预后进行分组，并进行统计学分析。
共收集到 141 例患者，其中 27 例死亡，114 例存活。通过统计学分析，入院时合并出血表现、意识障碍、淋巴细胞减少、血清脂肪酶升高和凝血酶原时间延长的患者是患者死亡的独立危险因素。通过绘制受试者工作特征曲线并计算曲线下面积，结果显示淋巴细胞计数的 AUC 为 0.670，95%CI（0.563-0.776），P=0.006；血清脂肪酶指数升高的 AUC 为 0.789，95%CI（0.699-0.878），p<0.001；凝血酶原时间延长的 AUC 为 0.749，95%CI（0.645-0.854），p<0.001。
入院时存在出血表现、意识障碍、淋巴细胞减少、血清脂肪酶升高和凝血酶原时间延长的患者更值得临床医生关注，需要早期有效干预，避免病情进一步恶化。
