Prognostic Nutritional Index As an Early Predictor of Mortality in Patients with Severe Fever with Thrombocytopenia Syndrome: Multicenter Retrospective Study in South Korea

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2025 Feb 25

PMID 40001073

Authors

Hyun Ji Woo

Tae-Kyu Kwon

Sang Taek Heo

Jeong Rae Yoo

Misun Kim

Jaeseong Oh

In-Gyu Bae

Sohyun Bae

Young-Ran Yoon

Miri Hyun

Hyun Ah Kim

Sook In Jung

Ki Tae Kwon

Soyoon Hwang

Uh Jin Kim

Gaeun Kang

Young Jun Kim

Jeong-Hwan Hwang

Min-Gul Kim

Affiliations

Soon will be listed here.

Abstract

Background And Aim: Severe fever with thrombocytopenia syndrome (SFTS) is a fatal tick-borne infectious disease lacking effective treatments or vaccines. Early identification of prognostic factors is essential for optimizing clinical management. This study investigated the predictors for mortality in SFTS patients.

Methods: We conducted a retrospective multicenter cohort study of 413 SFTS patients hospitalized in South Korea from 2013 to 2024. Clinical and laboratory data were comprehensively analyzed to evaluate associations between in-hospital mortality and various inflammatory, immune, and nutritional biomarkers. Cox regression and time-dependent receiver operating characteristic (ROC) analyses were performed to identify risk factors.

Results: 413 patients diagnosed with SFTS were included and In-hospital mortality was 17% (70/413). Multivariate Cox regression identified older age (HR: 1.042; 95% CI: 1.014-1.071), elevated PT(INR) (HR: 109.57; 95% CI: 19.79-606.57), and lower prognostic nutritional index (PNI) (HR: 0.937; 95% CI: 0.886-0.990) as early predictors of mortality. Time-dependent ROC analysis demonstrated predictive accuracy, with AUCs of 0.512 for age, 0.857 for PT(INR), and 0.694 for PNI at 30 days. Kaplan-Meier analysis revealed significant survival differences for patients stratified by PNI (< 40.75), PT(INR) (≥ 0.97), and age (≥ 59 years).

Conclusions: PNI, PT(INR), and age were identified as key early predictors of mortality in SFTS. PNI, as a novel biomarker, was found to be a useful index for risk level and treatment strategies in SFTS patients.

Clinical Trial Number: Not applicable.

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