Abstract
BackgroundCrimean–Congo hemorrhagic fever (CCHF) is a tick-borne viral disease with a high mortality rate. Although CCHF has been widely investigated over the past decade, a review of the literature indicated no data on the prognostic capacity of the mean platelet volume-to-platelet count ratio (MPVPCR) and the red cell distribution width-to-platelet count ratio (RDWPCR) for the systemic inflammatory response in patients with CCHF. This study aimed to evaluate the prognostic ability of MPVPCR and RDWPCR on mortality in patients with CCHF.MethodsA total of 807 patients that were admitted to the Cumhuriyet University Hospital’s Emergency Department from January 2010 to December 2018 were involved. The RDWPCR and MPVPCR were separately calculated via absolute blood red cell and platelet counts at the time of admission. Before performing receiver-operating characteristic (ROC) curve analysis to define the optimum cut-off values of MPVPCR and RDWPCR stepwise logistic regression analysis was used to determine the predictive factors related to mortality in CCHF patients.ResultsValues of both MPVPCR and RDWPCR were significantly lower in survivors than in non-survivors (MPVPCR: 0.20±0.23 versus 0.55±0.55, P<0.001; RDWPCR: 0.27±0.32 versus 0.77±0.77, P<0.001, respectively). The MPVPCR (odds ratio [OR], 5.95; P=0.048) was an independent predictor for the prognosis of mortality in CCHF patients. The area under the curve in the ROC curve analysis for MPVPCR was 0.876 with a cut-off of 0.21 (sensitivity 87%, specificity 76%).ConclusionAt the time of admission, MPVPCR might be a useful predictor of mortality in patients with CCHF.
Highlights
Crimean–Congo hemorrhagic fever (CCHF) is a tickborne viral disease with a high mortality rate; it has been reported in many parts of the world including Africa, Eastern Europe, the Middle East, and Asia.[1]
Logistic regression analysis showed that neutrophil, lymphocyte (OR=0.32; P
The present study is the first to reveal the clinical importance of MPVPCR as a potentially useful predictor for mortality in CCHF patients
Summary
Crimean–Congo hemorrhagic fever (CCHF) is a tickborne viral disease with a high mortality rate; it has been reported in many parts of the world including Africa, Eastern Europe, the Middle East, and Asia.[1] The CCHF mortality rate varies between 5% and 30%, and it has been reported to be 5.4% in Turkey.[2,3]. The second-stage symptoms usually appear four days after disease onset and include hemorrhage and bleeding from the nose, gums, lungs, skin of the hands and legs, stomach, and intestines. The majority of deaths occur between 5 and 14 days after disease onset due to excessive bleeding, persistent fever, anemia, circulatory shock, and disseminated intravascular coagulation.[4]. Crimean–Congo hemorrhagic fever (CCHF) is a tick-borne viral disease with a high mortality rate.
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