DOI QR코드

DOI QR Code

Risk Factors for Mechanical Ventilation in Patients with Scrub Typhus Admitted to Intensive Care Unit at a University Hospital

  • Moon, Kyoung Min (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Han, Min Soo (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Rim, Ch'ang Bum (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Lee, Jun Ho (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Kang, Min Seok (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Kim, Ji Hye (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Kim, Sang Il (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Jung, Sun Young (Department of Internal Medicine, Eulji University School of Medicine) ;
  • Cho, Yongseon (Department of Internal Medicine, Eulji University School of Medicine)
  • Received : 2015.08.19
  • Accepted : 2015.11.19
  • Published : 2016.01.31

Abstract

Background: The purpose of this study was to evaluate the risk factors for mechanical ventilation in the patients with scrub typhus admitted to intensive care unit (ICU) at a university hospital. Methods: We retrospectively selected and analyzed clinical data from the medical records of 70 patients (32 men, 38 women) admitted to the ICU with scrub typhus between 2004 and 2014. The patients had a mean${\pm}$standard deviation age of $71.2{\pm}11.1years$ and were evaluated in two groups: those who had been treated with mechanical ventilation (the MV group, n=19) and those who had not (the non-MV group, n=51). Mean ages of the MV group and the non-MV group were $71.2{\pm}8.3years$ and $71.2{\pm}11.1years$, respectively. Results: Significant differences between the two groups were observed with respect to acute respiratory failure (p=0.008), Acute Physiology and Chronic Health Evaluation (APACHE) II score (p=0.015), Sequential Organ Failure Assessment (SOFA) score (p=0.013), death (p=0.014), and ICU duration (p<0.01). Multivariate analysis indicated that the following factors were significantly associated with mechanical ventilation: acute respiratory failure (p=0.011), SOFA score (p=0.005), APACHE II score (p=0.011), platelet count (p=0.009), and lactate dehydrogenase (LDH) (p=0.011). Conclusion: Thus, five factors-acute respiratory failure, SOFA score, APACHE II score, platelet count, and LDH-can be the meaningful indicators for mechanical ventilation for the patients with scrub typhus admitted to ICU.

Keywords

References

  1. Cowan G. Rickettsial diseases: the typhus group of fevers: a review. Postgrad Med J 2000;76:269-72. https://doi.org/10.1136/pmj.76.895.269
  2. Varghese GM, Trowbridge P, Janardhanan J, Thomas K, Peter JV, Mathews P, et al. Clinical profile and improving mortality trend of scrub typhus in South India. Int J Infect Dis 2014;23: 39-43. https://doi.org/10.1016/j.ijid.2014.02.009
  3. Wang CC, Liu SF, Liu JW, Chung YH, Su MC, Lin MC. Acute respiratory distress syndrome in scrub typhus. Am J Trop Med Hyg 2007;76:1148-52.
  4. Thap LC, Supanaranond W, Treeprasertsuk S, Kitvatanachai S, Chinprasatsak S, Phonrat B. Septic shock secondary to scrub typhus: characteristics and complications. Southeast Asian J Trop Med Public Health 2002;33:780-6.
  5. Parola P, Miller RS, McDaniel P, Telford SR 3rd, Rolain JM, Wongsrichanalai C, et al. Emerging rickettsioses of the Thai-Myanmar border. Emerg Infect Dis 2003;9:592-5. https://doi.org/10.3201/eid0905.020511
  6. Lee CS, Hwang JH, Lee HB, Kwon KS. Risk factors leading to fatal outcome in scrub typhus patients. Am J Trop Med Hyg 2009;81:484-8.
  7. World Health Organization (WHO). WHO recommended surveillance standards. 2nd ed. [Internet]. Bethesda: World Health Organization; 2004 [cited 2015 Oct 1]. Available from: http://www.who.int/csr/resources/publications/surveillance/whocdscsr992.pdf.
  8. Griffith M, Peter JV, Karthik G, Ramakrishna K, Prakash JA, Kalki RC, et al. Profile of organ dysfunction and predictors of mortality in severe scrub typhus infection requiring intensive care admission. Indian J Crit Care Med 2014;18:497-502. https://doi.org/10.4103/0972-5229.138145
  9. Kim DM, Kim SW, Choi SH, Yun NR. Clinical and laboratory findings associated with severe scrub typhus. BMC Infect Dis 2010;10:108. https://doi.org/10.1186/1471-2334-10-108
  10. Ogawa M, Hagiwara T, Kishimoto T, Shiga S, Yoshida Y, Furuya Y, et al. Tsutsugamushi disease (scrub typhus) in Japan: clinical features. Kansenshogaku Zasshi 2001;75:359-64. https://doi.org/10.11150/kansenshogakuzasshi1970.75.359
  11. Tachibana N, Shishime E, Murai K, Tsuda K. Clinical and etiological studies of tsutsugamushi disease in Miyazaki district: correlation of serological type of R. tsutsugamushi to clinical feature. Kansenshogaku Zasshi 1990;64:76-9. https://doi.org/10.11150/kansenshogakuzasshi1970.64.76
  12. Venkategowda PM, Rao SM, Mutkule DP, Rao MV, Taggu AN. Scrub typhus: clinical spectrum and outcome. Indian J Crit Care Med 2015;19:208-13. https://doi.org/10.4103/0972-5229.154553
  13. Park SW, Lee CS, Lee CK, Kwak YG, Moon C, Kim BN, et al. Severity predictors in eschar-positive scrub typhus and role of serum osteopontin. Am J Trop Med Hyg 2011;85:924-30. https://doi.org/10.4269/ajtmh.2011.11-0134

Cited by

  1. The Characteristics and Clinical Course of Patients with Scrub Typhus and Queensland Tick Typhus Infection Requiring Intensive Care Unit Admission: A 23-year Case Series from Queensland, Tropical Aust vol.103, pp.6, 2016, https://doi.org/10.4269/ajtmh.20-0780
  2. The relationship between serum lactate dehydrogenase level and mortality in critically ill patients vol.15, pp.8, 2016, https://doi.org/10.2217/bmm-2020-0671