Clinical indicators for severe prognosis of scrub typhus.

[scrub typhus]

The study explored clinical risk characteristics that may be used to forecast scrub typhus severity under routine clinical practices .Retrospective data were collected from patients registered at two university-affiliated tertiary care hospitals in the north of Thailand , from 2004 to 2010 . Key information was retrieved from in -patient records , out patient cards , laboratory reports and registers . Patients were classified into three severity groups : nonsevere , severe (those with at least one organ involvement ), and deceased . Prognostic characteristics for scrub typhus severity were analyzed by a multivariable ordinal continuation ratio regression .A total of 526 patients were classified into nonsevere (n = 357 ), severe (n = 100 ), and deceased (n = 69 ). The significant multivariable prognostic characteristics for scrub typhus severity were increased body temperature (odds ratio [OR ] = 0 .58 , 95 % confidence interval [CI ] = 0 .45 -0 .74 , P < 0 .001 ), increased pulse rate (OR = 1 .03 , 95 % CI = 1 .01 -1 .05 , P < 0 .001 ), presence of crepitation (OR = 3 .25 , 95 % CI = 1 .52 -6 .96 , P = 0 .001 ), increased percentage of lymphocytes (OR = 0 .97 , 95 % CI = 0 .95 -0 .98 , P = 0 .001 ), increased aspartate aminotransferase (every 10 IU /L ) (OR = 1 .04 , 95 % CI = 1 .02 -1 .06 , P < 0 .001 ), increased serum albumin (OR = 0 .47 , 95 % CI = 0 .27 -0 .80 , P = 0 .001 ), increased serum creatinine (OR = 1 .83 , 95 % CI = 1 .50 -2 .24 , P < 0 .001 ), and increased levels of positive urine albumin (OR = 1 .43 , 95 % CI = 1 .17 -1 .75 , P < 0 .001 ).Patients suspicious of scrub typhus with low body temperature , rapid pulse rate , presence of crepitation , low percentage of lymphocyte , low serum albumin , elevated aspartate aminotransferase , elevated serum creatinine , and positive urine albumin should be monitored closely for severity progression .

Diseases
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Diseases presenting "increased body temperature (odds ratio [or" symptom

scrub typhus

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