Analysis of liver fibrosis equations as a potential role of predictive models in Crimean-Congo hemorrhagic fever

• Published in: Acta tropica 2024-03, Vol.251, p.107121-107121, Article 107121
• Main Authors: Bolat, Serkan, Büyüktuna, Seyit Ali, İpekten, Funda, Doğan, Kübra, Zararsız, Gökmen, Doğan, Halef Okan
• Format: Article
• Language: English
• Subjects: Crimean-Congo hemorrhagic fever; Liver; Liver fibrosis; Non-invasive; Serum biomarkers
• ISSN: 0001-706X; 1873-6254
• DOI: 10.1016/j.actatropica.2024.107121

•CCHF has a high mortality rate and determining disease severity remains challenging•Liver plays a crucial role in the replication of the virus and the progression of the disease.•Hepatic fibrous indices can be used to predict survival and intensive care needs in CCHF•S-INDEX, KING, and GPRI have the highest AUC in survival predictions•KING, GUCI, and GPRI show the best performance in predicting intensive care needs Crimean-Congo Hemorrhagic Fever (CCHF) is a formidable global health concern, characterized by its rapid onset and high fatality rate. Distinguishing between patients at different stages remains challenging because of overlapping clinical features. This study aimed to evaluate the diagnostic efficacy of 14 hepatic fibrosis indices for distinguishing fatal cases and intensive care unit requirement (ICU) in CCHF. This study enrolled 194 patients with confirmed CCHF. Laboratory measurements were performed using auto analyzers. Indirect indicators of fibrosis were calculated for each patient based on previously described formulas. Time-dependent receiver operating characteristic (tdROC) curve analyses were employed to evaluate the predictive effects of hepatic fibrosis indices on both intensive care unit requirement and overall survival among patients. Regarding the tdROC analyses results, the highest area under the curve statistics were obtained for the baseline S-INDEX, KING, and GPRI scores (0.920, 0.913, and 0.909 respectively) in the estimation of ten-day survival, and the baseline KING, Goteborg University cirrhosis index (GUCI), and gamma-glutamyl transferase to platelet ratio index (GPRI) scores (0.783, 0.773, and 0.769 respectively) in the estimation of intensive care requirements for up to ten days. S-index and KING index emerged as early predictors of ten-day survival, while KING, GUCI, and GPRI indices demonstrated predictive capabilities for ICU admission on the first day. The identified indices have the potential to assist healthcare providers in making timely and informed decisions regarding patient management and treatment strategies. Further research and validation are warranted to solidify the role of these hepatic fibrosis indices in the clinical setting and enhance their broader applicability in the management of CCHF. [Display omitted]