Analysis of the risk factors and prognosis for severe fever with thrombocytopenia syndrome associated encephalopathy

Abstract

ObjectiveSevere fever with thrombocytopenia syndrome (SFTS) is frequently associated with neurological injury, but there are currently few relevant studies. The goal of this study was to look at the risk factors for SFTA-associated encephalopathy (SFTSAE) and the short- and long-term prognosis of such patients. MethodsWe retrospectively studied 145 patients with SFTS who were treated at our hospital between May 2019 and November 2021. Clinical characteristics were collected, and patients were divided into two groups based on whether there was neurological injury during the disease: SFTSAE group and non-SFTSAE group. Univariate analysis was used to compare the differences in clinical data and outcomes between two groups, and multivariate Logistic regression analysis was used to reveal the independent risk factors for SFTSAE, and the predictive efficacy was assessed using the receiver operating characteristic (ROC) curve. Furthermore, survivors of SFTSAE were contacted by phone 6 months after discharge to assess the case fatality rate and quality of life. ResultsThe prevalence of SFTSAE was 22.7% (33/145). Bleeding symptoms, D-dimer level and blood amylase level were all independent risk factors for SFTSAE (P < 0.05). The combined AUC of these three factors was 0.969. Patients with SFTSAE had a 45.4% in-hospital mortality rate, and survivors had a largely normal quality of life after discharge. ConclusionPatients with SFTSAE frequently have multiple organ dysfunction, a high mortality rate, and a favorable long-term prognosis for survivors. Clinical manifestations of bleeding symptoms, elevated serum amylase, and elevated D-dimer were all independent risk factors for SFTSAE.