The Effect of Fetuin-A and Other Laboratory Paremeters on Prognosis and Mortality in Crimean-Congo Hemorrhagic Fever

Burak Demirci; Abuzer  Coskun

doi:10.18502/ijph.v52i1.11670

Burak Demirci Department of Emergency Medicine, Health Sciences University, Istanbul Bagcilar Education and Research Hospital, Bagcilar, İstanbul, Turkey
Abuzer Coskun Department of Emergency Medicine, Health Sciences University, Istanbul Bagcilar Education and Research Hospital, Bagcilar, İstanbul, Turkey

DOI: https://doi.org/10.18502/ijph.v52i1.11670

Keywords: Crimean Congo hemorrhagic fever; Emergency department; Mortality; Fetuin-A; Lactate

Abstract

Background: Crimean-Congo Hemorrhagic Fever (CCHF) is a disease with high morbidity and mortality, which is an important health problem in the world. Therefore, we aimed to evaluate the effects of plasma fetuin-A (FA) level, which is a new parameter in terms of prognosis and mortality of CCHF.

Methods: A total of 87 patients were included who presented to the Emergency Department, Bağcılar Training and Research Hospital, İstanbul, Turkey with the diagnosis of CCHF from Feb 1, 2019 to Feb 1, 2020. The patients were divided into three groups as tick bite, contact history, and endemic area travel according to the transmission type, and two groups according to the presence of mortality or not. The laboratory data of the patients were compared within these groups. Relationship of hemogram, C-reactive protein (CRP), D-Dimer, sedimentation, lactate, and FA levels between groups were evaluated.

Results: The average age of the patients was 62.52±14.94 years and 27(31%) of them were women. Mortality rates were in 6(6.9%) patients from endemic areas (P=0.015). While the FA level of the mortality group was 171.6±30.0 mg/L, it was 230.3±25.0 mg/L in the survivors (P=0.001). There was a moderate and strong negative correlation of FA level with mortality, tick history, and hospitalization. In ROC curve analysis of mortality and FA levels, parameters were determined as sensitivity 97.4% and specificity 96.2%.

Conclusion: In addition to FA levels, as anticipated by our hypothesis, lactate, CRP, and sedimentation values can be used to predict prognosis and mortality in cases of CCHF.