| ORIGINAL ARTICLE |
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| Year : 2021 | Volume
: 14
| Issue : 5 | Page : 209-213 |
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Circulatory and hepatic failure at admission predicts mortality of severe scrub typhus patients: A prospective cohort study
Ashok Kumar Pannu1, Atul Saroch1, Saurabh Chandrabhan Sharda1, Manoj Kumar Debnath1, Manisha Biswal2, Navneet Sharma1
1 Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Correspondence Address:
Navneet Sharma
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/1995-7645.314113
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Objective: To study the spectrum and outcome of severe scrub typhus in adult patients and to predict the hospital mortality by organ failure on admission.
Methods: This was a prospective observational cohort study conducted between July 2017 and October 2020 at the medical emergency centre of PGIMER, Chandigarh, India. One hundred and twenty-six patients aged ≥13 years were diagnosed with scrub typhus. Severe disease was defined as the presence of organ failure based on the Sequential Organ Failure Assessment (SOFA) score on admission.
Results: About two-thirds of the patients were from geographic regions outside the endemic sub-Himalayan belt. Fever (99.21%) and dyspnea (79.36%) were the most frequent complaints. Respiratory failure (81.75%) was the most common organ failure, followed by hepatic (52.38%), coagulative (47.62%), circulatory (33.33%), renal (21.43%), and cerebral dysfunction (13.49%). The median (Q1, Q3) SOFA score was 8 (6, 9), and 48.41% of the patients had a quick-SOFA score ≥2. Organ supports with invasive ventilation (40.48%), vasopressors (36.51%), and renal replacement therapy (7.14%) were frequently required. The in-hospital mortality was 11.90% and was independently predicted by circulatory and hepatic failures on multivariate logistic regression (OR 11.12, 95% CI 1.73-71.31 and OR 8.49, 95% CI 1.18-61.41, respectively).
Conclusions: Most patients had pulmonary dysfunction; circulatory or hepatic failure on admission strongly predicts death. |
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