PDF(Pubmed)
Abstract：
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
背景：自发现以来，严重发热伴血小板减少综合征（SFTS）的特点是进展迅速，预后差，没有具体的治疗方法。这项研究的目的是调查SFTS患者死亡率的早期预警指标。
方法：这是一项回顾性横断面研究。研究对象是2023年1月至2023年10月入院并确诊为SFTS的患者，以及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，根据预后分组，并进行统计分析。
结果：共收集了141例患者，其中27例患者死亡，114例患者为生存组。通过统计分析,合并出血表现的患者，意识障碍,淋巴细胞减少,脂肪酶升高,入院时凝血酶时间延长是患者死亡的独立危险因素。通过绘制受试者的工作特性曲线，以及计算曲线下的面积，结果显示,淋巴细胞减少症的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；延长凝血酶时间的AUC为0.749，95％CI（0.645-0.854），p<0.001。
结论：有出血表现的患者，意识障碍,淋巴细胞减少，血清脂肪酶升高，入院时凝血酶时间延长更值得临床医生注意，并需要早期和有效的干预措施，以避免进一步的疾病进展。
方法：这是一项回顾性横断面研究。研究对象是2023年1月至2023年10月入院并确诊为SFTS的患者，以及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，根据预后分组，并进行统计分析。
结果：共收集了141例患者，其中27例患者死亡，114例患者为生存组。通过统计分析,合并出血表现的患者，意识障碍,淋巴细胞减少,脂肪酶升高,入院时凝血酶时间延长是患者死亡的独立危险因素。通过绘制受试者的工作特性曲线，以及计算曲线下的面积，结果显示,淋巴细胞减少症的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；延长凝血酶时间的AUC为0.749，95％CI（0.645-0.854），p<0.001。
结论：有出血表现的患者，意识障碍,淋巴细胞减少，血清脂肪酶升高，入院时凝血酶时间延长更值得临床医生注意，并需要早期和有效的干预措施，以避免进一步的疾病进展。
