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Analysis of risk factors associated with fatal outcome among severe fever with thrombocytopenia syndrome patients from 2015 to 2019 in Shandong, China

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Abstract

To better understand the progression of severe fever with thrombocytopenia syndrome (SFTS), identify early predictors of mortality, and improve the cure rate, the present study aimed to analyze the demographic feature, clinical characteristics, and laboratory parameters of patients with SFTS and to explore the risk factors associated with fatal outcome. We retrospectively analyzed demographic feature, clinical characteristics, and laboratory parameters of 216 laboratory-confirmed SFTS patients in Shandong province between January 2015 and December 2019. Univariate analysis was used to assess the relevance between these factors and fatal outcome. Factors with P < 0.05 in univariate analysis were further analyzed using multivariable logistic regression analysis to identify the independent risk factors for mortality of SFTS. Age, five complications (including CNS symptoms, pulmonary infection, heart failure, arrhythmia, and bleeding events), and ten abnormal laboratory parameters (including serum viral load, blood platelet, ALT, AST, LDH, CK, CK-MB, Cr, serum Ca2+, and APTT) were statistically significant by univariate analysis. These factors were further analyzed by multivariable logistic regression analysis, and the results indicated that coma, pulmonary infection, high viral load, and prolonged APTT were associated with fatal outcome in SFTS patients. Our study identified four independent risk factors associated with fatal outcome for SFTS patients. The results were hoped to provide help for active treatment of SFTS. However, the identification of risk factors is not absolutely associated with fatal outcome. Patients’ risk should be assessed by dynamic observation of the changes in risk factor indicators.

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Acknowledgements

The authors thank the researchers from the clinical laboratory departments of the two hospitals. The authors also thank Dr. Shaowei Sang for his work on assistance of statistical analysis.

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Author notes

  1. Li Song and Yingjie Zhao had contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Infectious Diseases, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Wenhua Xi Road 107, Jinan, 250012, Shandong, China

    Li Song, Gang Wang & Lintao Sai

  2. Department of Rheumatology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Wenhua Xi Road 107, Jinan, 250012, Shandong, China

    Yingjie Zhao

  3. Department of Infectious Diseases, Affiliated Hospital of Qingdao University, Jiangsu Road 16, Qingdao, 266000, Shandong, China

    Deyu Huang

Authors
  1. Li Song
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  2. Yingjie Zhao
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  3. Gang Wang
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  4. Deyu Huang
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  5. Lintao Sai
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Contributions

Lintao Sai and Li Song conceived and designed the experiments. Li Song, Yingjie Zhao, and Gang Wang performed the experiments. Lintao Sai, Li Song, Yingjie Zhao, and Deyu Huang analyzed the data. Lintao Sai, Li Song, and Yingjie Zhao drafted and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lintao Sai.

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Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Medical Ethical Committee of Shandong University Qilu Hospital (Date: 2021–07-15/No: 2021–120).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Song, L., Zhao, Y., Wang, G. et al. Analysis of risk factors associated with fatal outcome among severe fever with thrombocytopenia syndrome patients from 2015 to 2019 in Shandong, China. Eur J Clin Microbiol Infect Dis 41, 1415–1420 (2022). https://doi.org/10.1007/s10096-022-04506-4

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  • DOI: https://doi.org/10.1007/s10096-022-04506-4

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