Clinical characteristics and risk factors for mortality of patients with severe fever with thrombocytopenia syndrome
10.3760/cma.j.issn.1000-6680.2016.01.004
- VernacularTitle:发热伴血小板减少综合征患者的临床特点及死亡相关危险因素分析
- Author:
Haiyan ZHAO
;
Jing SUN
;
Xiaomin YAN
;
Zhaoping ZHANG
;
Peixin SONG
;
Chao WU
- Publication Type:Journal Article
- Keywords:
Severe fever with thrombocytopenia syndrome bunyavirus;
Orthobunyavirus;
Death;
Risk factors
- From:
Chinese Journal of Infectious Diseases
2016;34(1):15-18
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical and laboratory characteristics of patients with severe fever with thrombocytopenia syndrome (SFTS ) and to identify the related risk factors for mortality .Methods Clinical features and laboratory parameters were collected from 40 SFTS patients (7 deaths and 33 survivors) .Dynamic changes of laboratory data were compared between the two groups , including white blood cell count (WBC ) , platelet count (PLT ) , alanine aminotransferase (ALT ) , aspartate aminotransferase (AST) ,creatine kinase (CK) ,lactate dehydrogenase (LDH) ,prothrombin time (PT) ,activated partial thromboplastin time (APTT) and thrombin time (TT) .Continuous variables with normal distribution were compared with t test ,and those with non‐normal distribution were compared with nonparametric test ;categorical variables were compared with χ2 test .Univariate Logistic regression was used to evaluate the risk factors associated with death .Results For the deceased patients and the survivors ,the APTT were 56 .40 s and 44 .45 s ,respectively (Z=5 .419 ,P=0 .04) at day 1—7 .Those were 66 .25 s and 36 .85 s ,respectively (Z=10 .112 ,P=0 .009) at day 8—10 ,and (125 .06 ± 11 .88) s and (33 .44 ± 6 .50) s ,respectively (t=45 .760 ,P<0 .01) at day 11—13 .At day 11—13 ,the ALT levels in deceased patients and survivors were (783 .00 ± 210 .12) U/L and (137 .33 ± 89 .59) U/L ,respectively (t=7 .989 ,P=0 .016) ,AST levels were 890 U/L and 99 U/L ,respectively (Z=60 .248 ,P <0 .01) , CK levels were 2 315 U/L and 314 U/L ,respectively (Z= 122 .065 , P< 0 .01) ,LDH levels were 1 075 U/L and 509 U/L ,respevtively (Z=44 .642 ,P<0 .01) ,PT were 16 s and 11 s ,respectively (Z=7 .917 ,P=0 .031) ,and TT were 120 s and 20 s ,respectively (Z=1 361 .674 ,P<0 .01) .Day 11—13 after the onset of illness was the critical stage for SFTS .Consciousness alteration (OR=6 .60 ,95% CI:2 .94—14 .80) ,bleeding (OR=9 .29 ,95% CI:1 .48—58 .47) ,PT> 15 s (OR= 24 .00 ,95% CI:1 .99—289 .60) ,APTT>70 s (OR= 42 .67 ,95% CI:3 .54—514 .85) and TT > 120 s (OR= 0 .14 ,95% CI:0 .02—0 .88) were risk factors for the death of SFTS patients (all P< 0 .05) .Conclusion Prolonged APT T ,T T and PT at early stage and progressively increasing during the disease course suggest poor prognosis of SFTS .
