Outcome Predictors in Scrub Typhus Requiring Ventilator and Vasopressor Support

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Epidemiology

Background:

• Scrub typhus is a significant cause of mortality in intensive care units.
• Predictors of mortality in severe scrub typhus cases requiring intensive support are not fully elucidated.
• Age and serum creatinine are established risk factors for mortality in scrub typhus.

Purpose of the Study:

• To identify factors predicting mortality in scrub typhus patients requiring both mechanical ventilation and vasopressor support.
• To analyze the association of demographic, clinical, and laboratory variables with mortality in this high-risk patient group.
• To provide insights for risk stratification and management of severe scrub typhus.

Main Methods:

• Retrospective analysis of 43 scrub typhus patients admitted to a Medical Intensive Care Unit.
• Patients requiring ventilator and vasopressor support were included.
• Bivariate and multivariate logistic regression analyses were performed to identify mortality predictors.

Main Results:

• The mortality rate was 56%, with all patients experiencing acute respiratory distress syndrome and septic shock.
• Significant predictors of mortality included increasing age (p=0.011), higher serum creatinine levels (p=0.046), and the number of vasopressors used (p=0.009).
• Specifically, age, serum creatinine >1.4 mg/dl, and requiring more than one vasopressor were independently associated with increased mortality risk.

Conclusions:

• In scrub typhus patients with acute respiratory distress syndrome and septic shock, advanced age, elevated serum creatinine, and the need for multiple vasopressors are significant predictors of mortality.
• These findings highlight key indicators for identifying high-risk patients requiring intensive care.
• Early recognition and management of these factors may improve outcomes in severe scrub typhus.