Yıl 2019, Cilt 3 , Sayı 6, Sayfalar 428 - 432 2019-06-28

Factors affecting mortality in Crimean-Congo hemorrhagic fever
Kırım Kongo kanamalı ateşinde mortaliteyi etkileyen faktörler

Nezih KAVAK [1] , Yunus GÜRBÜZ [2]


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.

Amaç: Kırım kongo kanamalı ateşi enfekte kenelerle bulaşan ve yüksek mortaliteye sahip viral bir hastalıktır. Kırım Kongo Kanamalı Ateşi (KKKA) hastalarında mortalite üzerinde etkili faktörleri belirlemeyi amaçladık.

Yöntemler: Hastaların yaş, cinsiyet, kene teması, kene sayısı, kenenin kim tarafından çıkarıldığı, kenenin vücuttaki lokalizasyonu, hastaneye başvuru süresi, semptomları, fizik muayene ve vital bulguları, laboratuvar parametreleri ve mortaliteye etki eden faktörler değerlendirildi. Çalışma retrospektif kohort olarak dizayn edildi.

Bulgular: 172 hastanın yaş ortancası 46 (18-78) yıl olup, olguların %73,8’i erkekti. Hastaneye başvurusu geç olan, baş ve boyun bölgesinden ısırılmış olan, ısıran kene sayısı fazla olan, keneler kendisi veya yakını tarafından çıkartılan hasaların ve bilinç bozukluğu olan hastaların mortalite sıklığı yüksek saptandı (sırası ile P=0,001, P<0,001, P<0,001, P<0,001, P=0,002). Olguların %87,2’sinde kanama saptandı. Mortal seyreden olgularda ekimoz, akciğerde sıvı, hematüri, hematemez ve melena sıklığı yüksekti (sırası ile P<0,001, P<0,001, P<0,001, P=0,006, P=0,006). Mortal seyreden hastalarda ateş ve kalp hızı anlamlı olarak yüksek; sistolik ve diyastolik kan basınçları ise anlamlı olarak düşük saptandı (sırası ile P<0,001, P<0.001, P=0,006, P<0,001). Mortal seyreden hastalarda beyaz küre (BK) sayısı, uluslararası normalleştirilmiş oran (INR), aspartat aminotransferaz (AST) ve alanin aminotransferaz (ALT) düzeyleri anlamlı olarak yüksek, platelet sayısı, anlamlı olarak düşük saptandı (hepsi için P<0,001). 

Sonuç: Kanamanın mortalite gelişmesinde temel faktörlerden biri olduğu saptandı. Kene sayısı, çıkartan kişi sayısı ve ısırılma yeri gibi faktörlerin mortalite üzerine etkili olduğu saptandı. Kan tetkikleri ve vital parametrelerin KKKA tanısı olan hastalarda mortal seyredecek hastaların belirlenmesinde kullanılabileceği kanısındayız.

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Bölüm Araştırma makalesi
Yazarlar

Orcid: 0000-0003-2751-0046
Yazar: Nezih KAVAK (Sorumlu Yazar)
Kurum: University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Emergency Department, Ankara, Turkey.
Ülke: Turkey


Orcid: 0000-0002-8772-0769
Yazar: Yunus GÜRBÜZ
Kurum: University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Infectious Disease and Clinical Microbiology, Ankara, Turkey.
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 28 Haziran 2019

Bibtex @araştırma makalesi { josam567579, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2019}, volume = {3}, pages = {428 - 432}, doi = {10.28982/josam.567579}, title = {Factors affecting mortality in Crimean-Congo hemorrhagic fever}, key = {cite}, author = {Kavak, Nezih and Gürbüz, Yunus} }
APA Kavak, N , Gürbüz, Y . (2019). Factors affecting mortality in Crimean-Congo hemorrhagic fever . Journal of Surgery and Medicine , 3 (6) , 428-432 . DOI: 10.28982/josam.567579
MLA Kavak, N , Gürbüz, Y . "Factors affecting mortality in Crimean-Congo hemorrhagic fever" . Journal of Surgery and Medicine 3 (2019 ): 428-432 <https://jsurgmed.com/tr/pub/issue/45558/567579>
Chicago Kavak, N , Gürbüz, Y . "Factors affecting mortality in Crimean-Congo hemorrhagic fever". Journal of Surgery and Medicine 3 (2019 ): 428-432
RIS TY - JOUR T1 - Factors affecting mortality in Crimean-Congo hemorrhagic fever AU - Nezih Kavak , Yunus Gürbüz Y1 - 2019 PY - 2019 N1 - doi: 10.28982/josam.567579 DO - 10.28982/josam.567579 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 428 EP - 432 VL - 3 IS - 6 SN - -2602-2079 M3 - doi: 10.28982/josam.567579 UR - https://doi.org/10.28982/josam.567579 Y2 - 2019 ER -
EndNote %0 Journal of Surgery and Medicine Factors affecting mortality in Crimean-Congo hemorrhagic fever %A Nezih Kavak , Yunus Gürbüz %T Factors affecting mortality in Crimean-Congo hemorrhagic fever %D 2019 %J Journal of Surgery and Medicine %P -2602-2079 %V 3 %N 6 %R doi: 10.28982/josam.567579 %U 10.28982/josam.567579
ISNAD Kavak, Nezih , Gürbüz, Yunus . "Factors affecting mortality in Crimean-Congo hemorrhagic fever". Journal of Surgery and Medicine 3 / 6 (Haziran 2019): 428-432 . https://doi.org/10.28982/josam.567579
AMA Kavak N , Gürbüz Y . Factors affecting mortality in Crimean-Congo hemorrhagic fever. J Surg Med. 2019; 3(6): 428-432.
Vancouver Kavak N , Gürbüz Y . Factors affecting mortality in Crimean-Congo hemorrhagic fever. Journal of Surgery and Medicine. 2019; 3(6): 428-432.
IEEE N. Kavak ve Y. Gürbüz , "Factors affecting mortality in Crimean-Congo hemorrhagic fever", Journal of Surgery and Medicine, c. 3, sayı. 6, ss. 428-432, Haz. 2019, doi:10.28982/josam.567579