Factors affecting mortality in Crimean-Congo hemorrhagic fever
Keywords:Crimean–Congo hemorrhagic fever, Mortality, Emergency department
Aim: Crimean-Congo hemorrhagic fever is a viral disease that is transmitted by infected ticks and has high mortality. We aim to determine the factors affecting mortality in patients with Crimean–Congo hemorrhagic fever (CCHF).
Methods: Age, gender, number of ticks, tick removal procedures, tick location, time to hospital admission, symptoms, physical examination findings, vital signs, laboratory parameters and factors affecting mortality were evaluated. The study was designed as a retrospective cohort study.
Results: The median age of the 172 patients was 46 (range, 18–78) years, and 73.8% of the patients were men. The mortality rate was high in patients with delayed time to hospital admission, those who were bitten on the head and neck region, those who had a high number of tick bites, those who had removed the tick themselves or had the tick removed by a relative and those who had impaired consciousness (P=0.001, P<0.001, P<0.001, P<0.001 and P=0.002, respectively). Bleeding was detected in 87.2% of cases. The frequency of ecchymosis, pleural effusion, hematuria, hematemesis and melena occurrence was high in non-survivors (P<0.001, P<0.001, P<0.001, P=0.006 and P=0.006, respectively). Fever and heart rate were significantly higher, systolic and diastolic blood pressure was significantly lower in non-survivors (P<0.001, P<0.001, P=0.006 and P<0.001, respectively). Additionally, the white blood cell (WBC) count, international normalized ratio (INR), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were significantly higher and platelet count were significantly lower in non-survivors (P<0.001 for all).
Conclusion: We found that in patients with CCHF, bleeding was a major factor associated with mortality. Factors such as a number of ticks, the number of people removing the ticks and tick location were found to affect mortality. We believe that blood tests and vital parameters can be used to predict mortality in patients with CCHF.
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