Circulatory and hepatic failure at admission predicts mortality of severe scrub typhus patients: A prospective cohort study

• 作者: Ashok Kumar Pannu Atul Saroch Saurabh Chandrabhan Sharda Manoj Kumar Debnath Manisha Biswal Navneet Sharma
• 来源期刊: 亚太热带医药杂志（英文版）
• 年，卷（期）: 2021,（5）
• 所属期刊栏目: Original Articles
• 页码范围: 209-213
• 页数: 5页
• 语种: 英文
• DOI: 10.4103/1995-7645.314113

摘要

Objective: To study the spectrum and outcome of severe scrub typhus in adult patients and to predict the hospital mortality by organ failure on admission.Methods: This was a prospective observational cohort study conducted between July 2017 and October 2020 at the medical emergency centre of PGIMER, Chandigarh, India. One hundred and twenty-six patients aged ≥13 years were diagnosed with scrub typhus. Severe disease was defined as the presence of organ failure based on the Sequential Organ Failure Assessment (SOFA) score on admission. Results: About two-thirds of the patients were from geographic regions outside the endemic sub-Himalayan belt. Fever (99.21％) and dyspnea (79.36％) were the most frequent complaints. Respiratory failure (81.75％) was the most common organ failure, followed by hepatic (52.38％), coagulative (47.62％), circulatory (33.33％), renal (21.43％), and cerebral dysfunction (13.49％). The median (Q1, Q3) SOFA score was 8 (6, 9), and 48.41％ of the patients had a quick-SOFA score ≥2. Organ supports with invasive ventilation (40.48％), vasopressors (36.51％), and renal replacement therapy (7.14％) were frequently required. The in-hospital mortality was 11.90％ and was independently predicted by circulatory and hepatic failures on multivariate logistic regression (OR 11.12, 95％ CI 1.73-71.31 and OR 8.49, 95％ CI 1.18-61.41, respectively). Conclusions: Most patients had pulmonary dysfunction; circulatory or hepatic failure on admission strongly predicts death.