Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease with a high fatality rate. The risk factors for death are not clearly identified, and there is no clinical score model to predict the prognosis. We retrospectively collected the clinical information of clinical symptoms and laboratory parameters of SFTS patients on admission. After analyzing the clinical characteristics of 179 SFTS patients, we found that an elevated level of neurologic symptoms, respiratory symptoms, viral load, and a lower level of monocyte percentage were the critical risk factors for mortality. We used the 4 variables to assemble a score formula named the SFTS index [SFTSI = 5 × Neurologic symptoms-level + 4 × Respiratory symptoms-level + 3 × LG10 Viral load - 2 × LN Monocyte% - 7]. The AURC of this model was 0.964, which was higher than the AURC 0.913 of the viral load especially among the patients with higher viral loads (0.936 vs 0.821). We identified that the neurologic symptoms, respiratory symptoms, viral load, and monocyte percentage were the critical risk factors for SFTS mortality. The clinical score model of SFTSI provides a practical method for clinicians to stratify patients with SFTS and to adopt prompt effective treatment strategies.

译文

严重发热伴血小板减少综合征 (SFTS) 是一种新出现的疾病,病死率很高。死亡的危险因素尚未明确,也没有临床评分模型来预测预后。我们回顾性收集了入院时SFTS患者的临床症状和实验室参数的临床信息。在分析179例SFTS患者的临床特征后,我们发现神经系统症状水平升高,呼吸道症状,病毒载量和单核细胞百分比水平降低是死亡的关键危险因素。我们使用4个变量组装了一个评分公式,称为SFTS指数 [sftsi   =   5  ×  神经症状水平 + 4  ×  呼吸道症状水平 + 3  ×   LG10病毒载量-2  ×  ln单核细胞 %-7]。该模型的AURC是0.964的,其高于AURC 0.913的病毒载量,特别是在病毒载量较高的患者中 (0.936 vs 0.821)。我们确定神经系统症状,呼吸道症状,病毒载量和单核细胞百分比是SFTS死亡率的关键危险因素。SFTSI的临床评分模型为临床医生对SFTS患者进行分层并迅速采取有效的治疗策略提供了实用的方法。

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