Department of Clinical Laboratory, Qishan Hospital of Yantai, 62 Huanshan Road, Zhifu District, Yantai, 264001, Shandong, The People's Republic of China.
Department of Infectious disease, Qishan Hospital of Yantai, 62 Huanshan Road, Zhifu District, Yantai, 264001, Shandong, The People's Republic of China.
BMC Infect Dis. 2024 Aug 23;24(1):858. doi: 10.1186/s12879-024-09752-9.
Severe fever with thrombocytopenia syndrome (SFTS) is a novel tick-borne infectious disease with a high fatality rate. Although several nomograms based on demographic and laboratory data have been reported to predict the prognosis of SFTS in recent studies, baseline serum glycated albumin (GA)/albumin (ALB) ratio included risk model has not been evaluated for the prediction of clinical outcome.
A total of 214 SFTS patients with integral data admitted to our hospital from May, 2020 to November, 2022 were included in this study. SFTS infection was confirmed by real time fluorescent quantitative PCR (qRT-PCR). The demographic characteristics, clinical and laboratory data were collected with in 24 h of admission and 1 to 2 days before discharge and were analysed retrospectively.
Fiffty-seven patients (26.6%) died. Multivariate logistic regression analysis showed that age, aspartate aminotransferase (AST), blood glucose (GLU), GA/ALB ratio, neutrophil counts (NEU) and lymphocyte percentage (LYM%) were the independent risk factors for mortality. A nomogram by these factors was created using RMS package in the R program. Area under the receiver operating characteristic (ROC) curve (AUC) of this nomogram was 0.88 (95% CI: 0.83, 0.93). This model showed the excellent net benefit, as revealed by the decision curve analysis. GA/ALB ratios were also independent risk factors for poor out clinical come in subgroups of patients with hyperglycemia on admission and with diabetes history. Nomograms were constructed by the independent risk factors in the subgroups. AUCs of the nomograms in the subgroups showed high predictive values for adverse prognosis.
GA/ALB ratios were independent risk factors for mortality in all SFTS patients and subgroups of with hyperglycemia on admission and diabetes history. The nomograms including GA/ALB ratio had high predictive value for adverse clinical outcome.The nomograms provide a basis for clinical decision-making for the treatment of SFTS patients in different clinical settings.
严重发热伴血小板减少综合征（SFTS）是一种新型蜱传传染病，死亡率较高。尽管最近的研究报道了几种基于人口统计学和实验室数据的列线图来预测 SFTS 的预后，但尚未评估基线血清糖化白蛋白（GA）/白蛋白（ALB）比值纳入风险模型对临床结局的预测价值。
本研究共纳入 2020 年 5 月至 2022 年 11 月期间我院收治的 214 例 SFTS 患者，采用实时荧光定量 PCR（qRT-PCR）确诊 SFTS 感染。收集患者入院后 24 小时内及出院前 1-2 天的人口统计学特征、临床和实验室数据，并进行回顾性分析。
57 例（26.6%）患者死亡。多因素 logistic 回归分析显示，年龄、天门冬氨酸氨基转移酶（AST）、血糖（GLU）、GA/ALB 比值、中性粒细胞计数（NEU）和淋巴细胞百分比（LYM%）是死亡的独立危险因素。使用 R 程序中的 RMS 包创建了基于这些因素的列线图。该列线图的受试者工作特征曲线（ROC）下面积（AUC）为 0.88（95%CI：0.83，0.93）。决策曲线分析显示，该模型具有良好的净获益。GA/ALB 比值也是入院时高血糖和有糖尿病史患者不良临床结局的独立危险因素。在亚组中构建了基于独立危险因素的列线图。亚组中列线图的 AUC 显示对不良预后具有较高的预测价值。
GA/ALB 比值是所有 SFTS 患者以及入院时高血糖和有糖尿病史患者死亡的独立危险因素。包含 GA/ALB 比值的列线图对不良临床结局具有较高的预测价值。该列线图为不同临床环境下 SFTS 患者的治疗提供了临床决策依据。
