Dynamic changes of activated partial thromboplastin time and correlation with mortality in patients with severe fever with thrombocytopenia syndrome: A retrospective cohort study.

IF 3.4 2区医学 Q1 PARASITOLOGY

PLoS Neglected Tropical Diseases Pub Date : 2025-05-22 eCollection Date: 2025-05-01 DOI:10.1371/journal.pntd.0013106

Huan Wang, Sisi Fang, Hua Wang, Xin Zheng

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引用次数: 0

Abstract

Background: Hemorrhagic manifestations are highly prevalent in severe fever with thrombocytopenia syndrome (SFTS) patients and are significantly associated with fatal outcomes. In this study, we investigated the dynamic changes of activated partial thromboplastin time (APTT) and their association with mortality in SFTS patients.

Methods: We conducted a retrospective study analyzing clinical data from SFTS patients admitted to our hospital between April 2017 and June 2024. The dynamic changes of APTT and their association with clinical outcomes were analyzed.

Results: A total of 788 SFTS patients were enrolled in this study, among whom 96 (12.18%) died during hospitalization. Multivariate logistic regression identified prolonged APTT as an independent predictor of mortality, along with older age, neurological symptoms, higher viral load, and elevated creatinine levels. Prolonged APTT was observed in 568(72.08%) patients upon admission and was associated with the development of neurological symptoms, bleeding, intensive care unit (ICU) transfer, and mortality. APTT≥2.0 times the upper limit of normal (ULN) was associated with significantly higher mortality (55%) and an increased likelihood of ICU transfer (10%). Restricted cubic splines (RCS) analysis revealed that when the APTT level exceeded specific thresholds (49.86s upon admission and 53.61s at the peak during hospitalization), the predicted mortality of patients with SFTS increased with rising APTT levels. Kinetic analysis showed that APTT levels exhibited a declining trend during hospitalization and returned to the normal range by the 6th day in the survival group, while it gradually increased, reaching its peak on the 3rd day and then gradually decreased in the non-survival group.

Conclusion: Prolonged APTT was prevalent among SFTS patients and was significantly associated with higher mortality. Monitoring APTT upon admission and its dynamic changes during hospitalization is recommended to enhance the management of SFTS patients.

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发热伴血小板减少综合征患者活化部分凝血活酶时间的动态变化及其与死亡率的相关性：一项回顾性队列研究

背景：出血性表现在发热伴血小板减少综合征（SFTS）患者中非常普遍，并且与死亡结果显著相关。在这项研究中，我们研究了SFTS患者活化部分凝血活素时间（APTT）的动态变化及其与死亡率的关系。方法：回顾性分析2017年4月至2024年6月我院收治的SFTS患者的临床资料。分析APTT的动态变化及其与临床预后的关系。结果：共纳入788例SFTS患者，其中96例（12.18%）在住院期间死亡。多因素logistic回归发现延长APTT是死亡率的独立预测因子，与年龄、神经系统症状、较高病毒载量和肌酐水平升高一起。568例（72.08%）患者在入院时观察到延长的APTT，并与神经症状、出血、重症监护病房（ICU）转移和死亡率的发展相关。APTT≥2.0倍正常上限（ULN）与死亡率显著升高（55%）和ICU转移可能性增加（10%）相关。限制性三次样条（Restricted cubic splines， RCS）分析显示，当APTT水平超过特定阈值（入院时49.86s，住院时峰值53.61s）时，SFTS患者的预测死亡率随APTT水平的升高而升高。动力学分析显示，存活组APTT水平在住院期间呈下降趋势，至第6天恢复到正常范围，而非存活组APTT水平逐渐升高，至第3天达到峰值，随后逐渐下降。结论：延长APTT在SFTS患者中普遍存在，并与较高的死亡率显著相关。建议在入院时监测APTT及其住院期间的动态变化，以加强对SFTS患者的管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PLoS Neglected Tropical Diseases PARASITOLOGY-TROPICAL MEDICINE

自引率

10.50%

发文量

723

期刊介绍： PLOS Neglected Tropical Diseases publishes research devoted to the pathology, epidemiology, prevention, treatment and control of the neglected tropical diseases (NTDs), as well as relevant public policy. The NTDs are defined as a group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of low-income and middle-income countries. Their impact on child health and development, pregnancy, and worker productivity, as well as their stigmatizing features limit economic stability. All aspects of these diseases are considered, including: Pathogenesis Clinical features Pharmacology and treatment Diagnosis Epidemiology Vector biology Vaccinology and prevention Demographic, ecological and social determinants Public health and policy aspects (including cost-effectiveness analyses).