Performance assessment of the SAPS II and SOFA scoring systems in Hanta virus Hemorrhagic Fever with Renal Syndrome. (October 2017)

• Record Type: Journal Article
• Authors: Yu, Zhenjun; Zhou, Ni; Li, Ali; Chen, Jie; Chen, Huazhong; He, Zebao; Yan, Fei; Zhao, Haihong; Zhu, Jiansheng
• Is Part Of: International journal of infectious diseases. Volume 63(2017:Oct.)
• Page Start: 88
• Page End: 94
• Publication Date: 2017-10
• Subjects: AIDS acquired immunodeficiency syndrome -- ALB albumin -- ALT alanine aminotransferase -- AMV Amur virus -- APTT activated partial thromboplastin time -- ARDS acute respiratory distress syndrome -- ARF acute renal failure -- AST aspartate transaminase -- AUC area under the ROC curve -- B Independent variable coefficient -- BUN blood urea nitrogen -- Ca serum calcium -- CD3 cluster of differentiation 3 -- CD4 cluster of differentiation 4 -- CD8 cluster of differentiation 8 -- CI confidence interval -- CK creatine kinase -- CRP C reactive protein -- CRRT continuous renal replacement therapy -- df degrees of freedom -- DIC disseminated intravascular coagulation -- DOBV dobrava virus -- ELISA enzyme-linked immunosorbent assay -- Fib fibrinogen -- FOBT fecal occult blood test -- GCS glasgow coma scale -- GFR glomerular filtration rate -- HB hemoglobin -- HCO3- bicarbonate ion -- HFRS Hemorrhagic Fever with Renal Syndrome -- HTNV hantaan virus -- ICU intensive care unit -- IHD intermittent hemodialysis -- K serum potassium -- LDH lactate dehydrogenase -- MODS multiple organ dysfunction syndrome -- MV mechanical ventilation -- Na serum sodium -- OR odds ratio -- PCT procalcitonin -- PLT platelet -- PT prothrombin time -- PUUV Puumala virus -- ROC receiver operating characteristic -- SAPS II simplified acute physiology score II -- SCr serum creatinine -- SE standard error -- SEOV Seoul virus -- SOFA sepsis-related organ failure assessment -- TB total bilirubin -- UA uric acid -- UOBT urine occult blood test -- WBC white blood cells; Hemorrhagic Fever with Renal Syndrome -- Simplified Acute Physiology Score II -- Sepsis-related Organ Failure Assessment; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2017.08.003
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: The sample comprised 384 patients with HFRS from January 2006 to February 2017. A new scoring system specifically for HFRS was formulated, named H-SOFA. PLT, PCT, TB, and FOBT were independent predictors of severe HFRS. SAPS II, SOFA, and H-SOFA had high predictive value for the progression of severe HFRS, with H-SOFA being the highest. Abstract: Background: Hemorrhagic Fever with Renal Syndrome (HFRS), caused by the hantavirus, is a natural infectious disease characterized by fever, hemorrhage and renal damage. China is the most severely endemic area for HFRS in the world. In recent years, critical scoring systems based on quantitative classification have become an important clinical tool for predicting and evaluating the prognosis of critical illness, and provide guidelines for clinical practice. Methods: The sample comprised 384 patients with HFRS treated in the Taizhou Hospital from January 2006 to February 2017. The patients were divided into the severe group and the mild group according to their clinical characteristics. By comparing the differences in clinical symptoms, signs and laboratory data between the two groups, the clinically relevant indicators of severe HFRS were explored. According to the previous studies, we incorporated the positive fecal occult blood test (FOBT) into the sepsis-related organ failure assessment (SOFA) tool and formulated a new scoring system specifically for HFRS, named H-SOFA. By comparing the simplified acute physiology score II (SAPS II), SOFA and H-SOFA scores of the two groups, their predictive values for the progression of HFRS were assessed. Results: Compared to the mild group, patients in the severe group had longer hospital stays; higher frequencies of nausea, vomiting, abdomen pain, signs of congestion and hemorrhage; and more pronounced impairment of liver and renal function. The levels of PLT, PCT, TB, and FOBT were positively correlated with the progression of HFRS (P < 0.001). Patients with HFRS in the severe group got significantly higher scores on the SAPS II, SOFA, and H-SOFA scoring systems (P < 0.001). The values of SAPS II, SOFA and H-SOFA, were significantly correlated with the severity of HFRS, and the AUC values were 0.90, 0.96, and 0.98, respectively. Conclusion: PLT, PCT, TB, and FOBT were independent predictors of severe HFRS; SAPS II, SOFA, and H-SOFA had high predictive value for the progression of severe HFRS, with H-SOFA being the highest.