Evaluation of risk factors for fatality in patients with Crimean-Congo haemorrhagic fever
Abstract number: P2051
Ataman Hatipoglu C., Bulut C., Yetkin M.A., Tuncer Ertem G., Erdinc F.S., Kaya Kilic E., Sari T., Kinikli S., Oral B., Demiroz A.P.
Objectives: Crimean-Congo Haemorrhagic Fever (CCHF) is a fatal viral infection caused by the CCHF virus. Fatality rate of the disease has been reported as 550%. In this study we aimed to evaluate the risk factors for fatality in patients with CCHF hospitalised in Ankara Training and Research Hospital, between 2006 and 2008.
Methods: All CCHF patients admitted to our clinic between 2006 and 2008 were evaluated. Serum samples were analysed with immunological (specific ELISA IgM and IgG) and molecular (RT-PCR) assays for the confirmation of the disease. All patients with positive IgM antibodies and/or PCR for CCHF virus in blood were included to the study. To determine the predictors of fatality among patients with CCHF, we compared epidemiological, clinical and laboratory findings of the fatal cases with survivors.
Results: Ninety-three confirmed CCHF patients were included in the study. Fifty-six (60.2%) of them were female, mean age was 48.4±17.7 years (1483 years) and mean hospital stay was 7.9±3.0 days (118 days). Five patients were died (5.4%). The age, gender, the rate of tick bite, time from tick bite to admission to the hospital, hospital stay, initial complaints (fever, fatigue, nausea, vomiting, myalgia, abdominal pain, headache and skin eruption) were not significantly different between fatal and non-fatal cases (p > 0.05). The rates of haemorrhage, diarrhoea and confusion were higher in fatal cases compared with non-fatal cases (p < 0.05). Mean aspartate aminotransferase (AST), alanin aminotransferase (ALT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), creatin phosphokinase (CK), and C-reactive protein (CRP) levels were higher in fatal cases than the non-fatal ones, activated partial thromboplastin time (aPTT) was longer and mean platelet counts were lower (p < 0.05). There was no differences between ribavirin and steroid therapies, and fresh frozen plasma, platelet and erythrocyte infusions between the two groups (p > 0.05). By multivariate analysis only elevated serum ALT, AST, LDH levels and prolongation of aPTT were independently risk factors associated with fatality.
Conclusions: In this study we found serum AST, ALT, LDH and aPTT values as predictors for fatality among patients with CCHF. We suggest that for patients who had these abnormal laboratory findings, physicians should be aware of high fatality risk.
|Session name:||19th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Helsinki, Finland, 16 - 19 May 2009|
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