Zhang Qun, Wang Jian, Zhang Shaoqiu, Wang Huali, Zhang Zhiyi, Geng Yu, Pan Yifan, Jia Bei, Xiong Yali, Yan Xiaomin, Li Jie, Wu Chao, Huang Rui, Zhu Xiaoli
Department of Infectious Diseases, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
Heliyon. 2024 Sep 13;10(18):e37907. doi: 10.1016/j.heliyon.2024.e37907. eCollection 2024 Sep 30.
The clinical significance of gastrointestinal (GI) symptoms in patients with severe fever and thrombocytopenia syndrome (SFTS) is poorly characterized. This study aimed to determine the prevalence and effect of GI symptoms on the prognosis of patients with SFTS.
This was a retrospective multi-center cohort study that included hospitalized patients with SFTS from three institutions between October 2010 and August 2022. The risk factors for mortality and intensive care unit (ICU) admission were identified by Cox and logistic regression analyses, respectively. Kaplan-Meier curves were used to analyze the cumulative mortality risk.
Among 304 patients, the median age was 62.0 years and 51.0 % of the patients were male. A total of 202 patients (66.4 %) had at least one GI symptom on admission. Diarrhea (69.8 %) and nausea (57.4 %) were the most common symptoms. Patients with GI symptoms had lower male proportion (46.0 % vs. 60.8 %, P = 0.015), higher aspartate aminotransferase (177.5 U/L vs. 118.0 U/L, P = 0.010) and lactic dehydrogenase (771.0 U/L vs. 666.5 U/L, P = 0.017) levels than that of patients without GI symptoms. However, there was no significant difference in mortality rates (23.8 % vs. 21.6 %, P = 0.668) and ICU admission (14.4 % vs. 12.7 %, P = 0.701) between SFTS patients with and without GI symptoms. Multivariate analysis suggested that GI symptoms at admission were not associated with mortality and ICU admission.
GI symptoms are common in patients with SFTS. However, the presence of GI symptoms was not an independent risk factor for poor prognosis.
严重发热伴血小板减少综合征（SFTS）患者胃肠道（GI）症状的临床意义尚不明确。本研究旨在确定GI症状在SFTS患者中的发生率及其对预后的影响。
这是一项回顾性多中心队列研究，纳入了2010年10月至2022年8月期间来自三家机构的住院SFTS患者。分别通过Cox回归和逻辑回归分析确定死亡率和重症监护病房（ICU）入住的危险因素。采用Kaplan-Meier曲线分析累积死亡风险。
304例患者中，中位年龄为62.0岁，51.0%为男性。共有202例患者（66.4%）入院时至少有一项GI症状。腹泻（69.8%）和恶心（57.4%）是最常见的症状。有GI症状的患者男性比例较低（46.0%对60.8%，P = 0.015），天冬氨酸转氨酶（177.5 U/L对118.0 U/L，P = 0.010）和乳酸脱氢酶（771.0 U/L对666.5 U/L，P = 0.017）水平高于无GI症状的患者。然而，有GI症状和无GI症状的SFTS患者死亡率（23.8%对21.6%，P = 0.668）和ICU入住率（14.4%对12.7%，P = 0.701）无显著差异。多因素分析表明，入院时的GI症状与死亡率和ICU入住无关。
GI症状在SFTS患者中很常见。然而，GI症状的存在并非预后不良的独立危险因素。
