Prediction of an outcome in Crimean hemorrhagic fever


DOI: https://dx.doi.org/10.18565/epidem.2019.9.4.28-34

Abuova G.N., Pshenichnaya N.Yu., Berdalieva F.A., Khodzhabekov B.K., Ermakova L.A.

1) South Kazakhstan Medical Academy, Shymkent, Republic of Kazakhstan; 2) National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Ministry of Health of Russia, Moscow, Russia; 3) Rostov State Medical University, Ministry of Health of Russia, Rostov-on-Don, Russia; 4) Rostov Research Institute of Microbiology and Parasitology, Russian Federal Service for Surveillance of Consumer Rights Protection and Human Well-Being, Rostov-on-Don, Russia
When medical care is rendered to seriously ill patients with Crimean hemorrhagic fever (CHF), there is an increased risk of healthcare-associated infection (HCAI) at first- and second-level hospitals. There is a need for the uniform assessment of disease severity, according to which the patient at high risk of death should be immediately transferred to a third-level hospital.
Objective. To develop a procedure for assessing the risk of death in patients with CHF, by determining the clinical and laboratory values available at first-/second-level hospitals on the day of hospitalization.
Materials and methods. By analyzing four procedures for evaluating the severity of the condition in patients with CHF, the investigators designed a mortality risk prediction scale based on 12 clinical and laboratory parameters and 2–4 gradations of each parameter, which was reflected in 32 criteria of the scale. The scale was tested based on the retrospective analysis of case records of 52 patients with CHF who had been treated at the hospitals of the Turkestan Region, Republic of Kazakhstan, in 2000–2018.
Results. The patients’ clinical and laboratory values were rated using the designed point scale for assessing the risk of death in patients with CHF. Each parameter was assigned a certain number of scores and then their total amount was determined. When the patient had a total score of ≥ 11, he was predicted to be at high risk of an unfavorable outcome. When the total score was < 11, the risk for an adverse outcome was considered to be low in patients with CHF. The sensitivity of the proposed procedure was 100%; its specificity was 98%, and the predicted value was 90%.
Conclusion. The proposed procedure with a high probability allows prediction of a poor outcome of CHF; it should be used at first- and second-level hospitals to optimize healthcare provision to patients with this disease and to prevent HCAI.
Keywords: unfavorable outcome, prediction scale, risk assessment, Crimean hemorrhagic fever
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    • About the Autors

    Prof. Gulzhan N. Аbuova, Cand. Med. Sci., Head, Department of Infectious Diseases and Dermatovenerology, South Kazakhstan Medical Academy, Shymkent, Republic of Kazakhstan; е-mail: dr.abuova @gmail.com; ORCID:http://orcid.org/0000-0002-1210-2018
    Prof. Nataliya Yu. Pshenichnaya, MD, Infectiologist, National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Ministry of Health of Russia; Leading Researcher, Rostov State Medical University, Ministry of Health of Russia, Rostov-on-Don, Russia; е-mail: natalia-pshenichnaya@yandex.ru; ORCID: https://orcid.org/0000-0003-2570-711X
    Farida A. Berdalieva, Cand. Med. Sci., Associate Professor, Department of Infectious Diseases and Dermatovenereology, South Kazakhstan Medical Academy, Shymkent, Republic of Kazakhstan; е-mail: fberdalieva@mail.ru; ORCID: https://orcid.org/0000-0001-9680-1678
    Bakytjan K. Khodzhabekov, Cand. Med. Sci., Associate Professor, Department of Infectious Diseases and Dermatovenereology, South Kazakhstan Medical Academy, Shymkent, Republic of Kazakhstan; е-mail: bk_kojabekov@mail.ru
    Larisa A. Ermakova, Cand. Med. Sci., Assistant, Department of Infectious Diseases, Ministry of Health of Russia; Head, Clinic of Infectious and Parasitic Diseases, Rostov Research Institute of Microbiology and Parasitology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Rostov-on-Don, Russia; е-mail: 79281905477@yandex.ru; ORCID: https://orcid.org/0000-0002-8918-2271


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