Lactate Dehydrogenase/Albumin to Urea Ratio: A Novel Prognostic Indicator for Adverse Outcomes in Patients With Severe Fever With Thrombocytopenia Syndrome

IF 6.8 3区医学 Q1 VIROLOGY

Journal of Medical Virology Pub Date : 2025-06-06 DOI:10.1002/jmv.70428

Ruihua Zhang, Yameng Mu, Mengyuan Zhang, Hongxiao Wu, Yanli Xu, Chenxi Zhao, Zishuai Liu, Ling Lin, Wei Zhang, Yaxian Kong, Zhihai Chen

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Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with significant mortality risks. This study evaluated the predictive value of the lactate dehydrogenase/albumin to urea ratio (LAU) for lethal outcomes in SFTS patients. Clinical data from 348 patients (295 survivors, 53 non-survivors) admitted to Yantai Infectious Disease Hospital (2022-2023) were analyzed. Multivariate analysis identified older age, SFTS-associated encephalopathy, SFTSV RNA, decreased albumin and serum calcium, increased lactate dehydrogenase, and elevated LAU as independent mortality risk factors. LAU demonstrated strong predictive accuracy (AUC: 0.79; 95% CI: 0.72-0.85; sensitivity 69%, specificity 75%), with an optimal cutoff of 144.685 U·mmol/g·L. Survival analysis linked high LAU to poor prognosis, and longitudinal trends showed decreasing LAU with recovery in survivors but rising levels in non-survivors. These findings highlight LAU as a novel, practical biomarker for early risk stratification and prognosis improvement in SFTS.

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乳酸脱氢酶/白蛋白尿素比：发热伴血小板减少综合征患者不良预后的新预后指标

发热伴血小板减少综合征（SFTS）是一种具有显著死亡风险的新兴传染病。本研究评估了乳酸脱氢酶/白蛋白尿素比（LAU）对SFTS患者致死结果的预测价值。分析了烟台市传染病医院2022-2023年收治的348例患者（295例幸存者，53例非幸存者）的临床资料。多因素分析发现，年龄较大、sfts相关脑病、SFTSV RNA、白蛋白和血钙降低、乳酸脱氢酶升高和LAU升高是独立的死亡危险因素。LAU具有较强的预测准确性(AUC: 0.79；95% ci: 0.72-0.85；灵敏度69%，特异性75%)，最佳截止值为144.685 U·mmol/g·L。生存分析将高LAU与不良预后联系起来，纵向趋势显示，LAU随着幸存者的康复而下降，而非幸存者的水平上升。这些发现强调了LAU作为SFTS早期风险分层和预后改善的一种新颖实用的生物标志物。

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

Journal of Medical Virology 医学-病毒学

CiteScore

23.20

自引率

2.40%

发文量

777

审稿时长

1 months

期刊介绍： The Journal of Medical Virology focuses on publishing original scientific papers on both basic and applied research related to viruses that affect humans. The journal publishes reports covering a wide range of topics, including the characterization, diagnosis, epidemiology, immunology, and pathogenesis of human virus infections. It also includes studies on virus morphology, genetics, replication, and interactions with host cells. The intended readership of the journal includes virologists, microbiologists, immunologists, infectious disease specialists, diagnostic laboratory technologists, epidemiologists, hematologists, and cell biologists. The Journal of Medical Virology is indexed and abstracted in various databases, including Abstracts in Anthropology (Sage), CABI, AgBiotech News & Information, National Agricultural Library, Biological Abstracts, Embase, Global Health, Web of Science, Veterinary Bulletin, and others.