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Which scoring system is effective in predicting mortality in patients with Crimean Congo hemorrhagic fever? A
Mehmet Bakir1, Caner Öksüz1, Faruk Karakeçili2
1Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University, Sivas, Turkey.
Insights
The Severity Grading System (SGS), SOFA, and APACHE II best predict mortality in Crimean-Congo Hemorrhagic Fever (CCHF) patients. qSOFA was not significant for early mortality prediction.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- Crimean-Congo Hemorrhagic Fever (CCHF) is a severe tick-borne viral illness with significant mortality.
- Effective scoring systems are crucial for evaluating CCHF patient prognosis and guiding clinical management.
- Existing scoring systems require comparative analysis for optimal application in CCHF care.
Purpose of the Study:
- To compare the efficacy of qSOFA, SOFA, APACHE II, and SGS in predicting mortality among CCHF patients.
- To determine the best scoring system for evaluating the clinical course of CCHF.
- To assess the predictive performance of scoring systems at different time points during hospitalization.
Main Methods:
- A retrospective study involving 388 CCHF patients diagnosed via PCR and/or IgM positivity across five centers.
- Calculation and evaluation of qSOFA, SOFA, APACHE II, and SGS scores at admission, 72 hours, and 120 hours.
- Correlation analysis between scoring systems and mortality prediction in survivors and non-survivors.
Main Results:
- SGS, SOFA, and APACHE II demonstrated superior performance in predicting mortality at admission.
- All evaluated scoring systems (qSOFA, SOFA, APACHE II, SGS) were significant predictors of mortality at 72 and 120 hours.
- A strong positive correlation was observed between qSOFA, SOFA, and SGS scores in survivors; APACHE II showed a weaker correlation.
- A one-unit increase in SGS score multiplied the odds of death by 12.818.
Conclusions:
- SGS, SOFA, and APACHE II are the most effective scoring systems for predicting CCHF patient mortality at admission and during the disease course.
- qSOFA demonstrated limited utility for predicting early mortality in CCHF.
- These findings support the use of SGS, SOFA, and APACHE II for enhanced CCHF patient monitoring and risk stratification.
Abstract:
We aimed to decide which scoring system is the best for the evaluation of the course of Crimean-Congo Hemorrhagic Fever (CCHF) by comparing scoring systems such as qSOFA (quick Sequential Organ Failure Assessment), SOFA (Sequential Organ Failure Assessment), APACHE II (Acute Physiology and Chronic Health Evaluation II) and SGS (Severity Grading System) in centers where patients with CCHF were monitored. The study was conducted with patients diagnosed with CCHF in five different centers where the disease was encountered most commonly. Patients having proven PCR and/or IgM positivity for CCHF were included in the study. The scores of the scoring systems on admission, at the 72nd hour and at the 120th hour were calculated and evaluated. The data of 388 patients were obtained from five centers and evaluated. SGS, SOFA and APACHE II were the best scoring systems in predicting mortality on admission. All scoring systems were significant in predicting mortality at the 72nd and 120th hours. On admission, there was a correlation between the qSOFA, SOFA and APACHE II scores and the SGS scores in the group of survivors. All scoring systems had a positive correlation in the same direction. The correlation coefficients were strong for qSOFA and SOFA, but poor for APACHE II. A one-unit rise in SGS increased the probability of death by 12.818 times. qSOFA did not provide significant results in predicting mortality on admission. SGS, SOFA and APACHE II performed best at admission and at the 72nd and 120th hours.
