Journal Article

Serum mAST/ALT ratio had high predictive value for adverse outcome of severe fever with thrombocytopenia syndrome with severe condition

Zou, Zhiqiang, Wang, Li, Liu, Youde, Qu, Renliang

2023

Overview

Background Severe fever with thrombocytopenia syndrome (SFTS) usually demonstrates multi-organ injury with a high mortality rate. This study aimed to investigate associations of serum aspartate/alanine aminotransferase (AST)/ALT, cytosolic AST (cAST)/ALT and mitochondrial AST (mAST)/ALT ratios with the prognosis of SFTS patients. Methods A total of 355 confirmed SFTS patients were included. Clinical and laboratory data were compared between survivors and nonsurvivors. Logistic regression analysis was used to assess the independent risk factors for fatality in all patients and those admitted to the intensive care unit (ICU). The predictive values of the risk factors and constructed risk models were evaluated. Results Mean age and biochemical parameters were significantly greater in nonsurvivors than in survivors. In ICU patients, the three ratios, high-sensitivity troponin I (hsTnI), creatine kinase (CK), lactate dehydrogenase (LDH) and α-hydroxybutyrate dehydrogenase (α-HBDH) were elevated markedly in nonsurvivors than in survivors. Multivariate logistic regression analysis showed that age, three ratios and α-HBDH were independent risk factors for mortality in all patients. Only the three ratios were independent risk factors for death in ICU patients. Risk Models (M1, M2 and M3) and simplified models (sMs) containing the three ratios respectively had comparatively high predictive values for fatality in all patients with area under ROC curves (AUCs) > 0.85. In ICU patients, mAST/ALT ratio had the highest predictive value, sensitivity and odds ratio (OR) for mortality among three ratios. Conclusion AST/ALT, cAST/ALT and mAST/ALT ratios were associated with unfavorable clinical outcome of SFTS. The prognostic value of mAST/ALT ratio was higher in severe cases.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Age / Alanine / Alanine Transaminase / Aminotransferases / Analysis / Aspartate Aminotransferases / AST/ALT ratio / Calcium-binding protein / Care and treatment / cAST/ALT ratio / Comparative analysis / Complications and side effects / Correlation analysis / Creatine / Creatine Kinase / Dehydrogenase / Dehydrogenases / Development and progression / Ethics / Fatalities / Fever / Health aspects / Health risk assessment / Hospital patients / Hospitals / Humans / Hyperthermia / Infections / Infectious Diseases / Internal Medicine / Kinases / L-Lactate Dehydrogenase / Lactate dehydrogenase / Lactic acid / Liver / mAST/ALT ratio / Medical Microbiology / Medical prognosis / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Metabolism / Methods / Mitochondria / Mitochondrial DNA / Mortality / Parasitology / Prognosis / Ratios / Regression analysis / Retrospective Studies / Risk assessment / Risk factor / Risk factors / Sensitivity / Sepsis / Severe Fever with Thrombocytopenia Syndrome / Software / Statistical analysis / Survival / Survival analysis / Taiwan / Thrombocytopenia / Tropical Medicine / Troponin I