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Background and aim <p>Severe fever with thrombocytopenia syndrome (SFTS) is a fatal tick-borne infectious disease lacking effective treatments or vaccines. Early identification of prognostic factors is essential for optimizing clinical management. This study investigated the predictors for mortality in SFTS patients.</p> Methods <p>We conducted a retrospective multicenter cohort study of 413 SFTS patients hospitalized in South Korea from 2013 to 2024. Clinical and laboratory data were comprehensively analyzed to evaluate associations between in-hospital mortality and various inflammatory, immune, and nutritional biomarkers. Cox regression and time-dependent receiver operating characteristic (ROC) analyses were performed to identify risk factors.</p> Results <p>413 patients diagnosed with SFTS were included and In-hospital mortality was 17% (70/413). Multivariate Cox regression identified older age (HR: 1.042; 95% CI: 1.014–1.071), elevated PT(INR) (HR: 109.57; 95% CI: 19.79–606.57), and lower prognostic nutritional index (PNI) (HR: 0.937; 95% CI: 0.886–0.990) as early predictors of mortality. Time-dependent ROC analysis demonstrated predictive accuracy, with AUCs of 0.512 for age, 0.857 for PT(INR), and 0.694 for PNI at 30 days. Kaplan-Meier analysis revealed significant survival differences for patients stratified by PNI (&lt; 40.75), PT(INR) (≥ 0.97), and age (≥ 59 years).</p> Conclusions <p>PNI, PT(INR), and age were identified as key early predictors of mortality in SFTS. PNI, as a novel biomarker, was found to be a useful index for risk level and treatment strategies in SFTS patients.</p> Clinical trial number <p>Not applicable.</p>

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Prognostic nutritional index as an early predictor of mortality in patients with severe fever with thrombocytopenia syndrome: multicenter retrospective study in South Korea

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月25日

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  • Hyun Ji Woo,
  • Tae-Kyu Kwon,
  • Sang Taek Heo,
  • Jeong Rae Yoo,
  • Misun Kim,
  • Jaeseong Oh,
  • In-Gyu Bae,
  • Sohyun Bae,
  • Young-Ran Yoon,
  • Miri Hyun,
  • Hyun ah Kim,
  • Sook In Jung,
  • Ki Tae Kwon,
  • Soyoon Hwang,
  • Uh Jin Kim,
  • Gaeun Kang,
  • Young Jun Kim,
  • Jeong-Hwan Hwang,
  • Min-Gul Kim

摘要

Background and aim

Severe fever with thrombocytopenia syndrome (SFTS) is a fatal tick-borne infectious disease lacking effective treatments or vaccines. Early identification of prognostic factors is essential for optimizing clinical management. This study investigated the predictors for mortality in SFTS patients.

Methods

We conducted a retrospective multicenter cohort study of 413 SFTS patients hospitalized in South Korea from 2013 to 2024. Clinical and laboratory data were comprehensively analyzed to evaluate associations between in-hospital mortality and various inflammatory, immune, and nutritional biomarkers. Cox regression and time-dependent receiver operating characteristic (ROC) analyses were performed to identify risk factors.

Results

413 patients diagnosed with SFTS were included and In-hospital mortality was 17% (70/413). Multivariate Cox regression identified older age (HR: 1.042; 95% CI: 1.014–1.071), elevated PT(INR) (HR: 109.57; 95% CI: 19.79–606.57), and lower prognostic nutritional index (PNI) (HR: 0.937; 95% CI: 0.886–0.990) as early predictors of mortality. Time-dependent ROC analysis demonstrated predictive accuracy, with AUCs of 0.512 for age, 0.857 for PT(INR), and 0.694 for PNI at 30 days. Kaplan-Meier analysis revealed significant survival differences for patients stratified by PNI (< 40.75), PT(INR) (≥ 0.97), and age (≥ 59 years).

Conclusions

PNI, PT(INR), and age were identified as key early predictors of mortality in SFTS. PNI, as a novel biomarker, was found to be a useful index for risk level and treatment strategies in SFTS patients.

Clinical trial number

Not applicable.