TY - JOUR
T1 - Multi-center prospective evaluation of discharge criteria for hospitalized patients with Crimean-Congo Hemorrhagic Fever
AU - Leblebicioglu, Hakan
AU - Sunbul, Mustafa
AU - Barut, Sener
AU - Buyuktuna, Seyit Ali
AU - Ozkurt, Zulal
AU - Yapar, Derya
AU - Yilmaz, Gurdal
AU - Guner, Rahmet
AU - But, Ayse
AU - Cicek Senturk, Gonul
AU - Murat, Naci
AU - Ozaras, Resat
AU - Bakir, Mehmet
AU - Baykam, Nurcan
AU - Bodur, Hurrem
AU - Bozkurt, Ilkay
AU - Koksal, Iftihar
AU - Sencan, Irfan
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Introduction The information of discharge criteria in patients with Crimean-Congo Hemorrhagic Fever (CCHF) is limited. In this study, we aimed to determine the clinical and laboratory parameters used in discharging the patients by the experienced centers. Materials and methods The study was done in 9 reference centers of CCHF from May 1, 2015 to December 1, 2015 and included laboratory-confirmed patients with CCHF. The study was prospective, observational and non-interventional. Results The study included 260 patients. Mean age was 51.3 ± 16.3 years; 158 (60.8%) were male. Mean hospital stay was 7 ± 2.6 days. The decision of discharging was taken considering clinical and laboratory findings. On discharge, no patients had fever or hemorrhage. The patients were followed-up clinically and a repeat CCHF PCR was not studied. All centers considered the following criteria for discharge: no fever and hemorrhage, improvement in clinical findings and laboratory studies. For all patients except one, platelet count was >50,000/mm3 and had a tendency to increase. Prothrombin time and international normalized ratio (INR) were normal in 258 (99.6%) and 254 (98.1%) patients respectively. Alanine aminotransferase (ALT) was either normal or not higher than 10-fold and had a tendency to decrease in 259 (99.6%) patients. ALT and aspartate aminotransferase (AST) levels were not taken as discharge criteria with priority. During 30 days following the discharge, complication, relapse, or secondary transmission were not reported. Conclusions The discharging practice of the centers based on clinical and laboratory parameters seems safe considering no complications, relapses, or secondary infection thereafter. Current discharge practice of the centers composed of no fever and hemorrhage, improvement in clinical findings, platelet count of either >100,000/mm3 or >50,000/mm3 with a tendency to increase, and normal bleeding tests can be used as the criteria of discharge.
AB - Introduction The information of discharge criteria in patients with Crimean-Congo Hemorrhagic Fever (CCHF) is limited. In this study, we aimed to determine the clinical and laboratory parameters used in discharging the patients by the experienced centers. Materials and methods The study was done in 9 reference centers of CCHF from May 1, 2015 to December 1, 2015 and included laboratory-confirmed patients with CCHF. The study was prospective, observational and non-interventional. Results The study included 260 patients. Mean age was 51.3 ± 16.3 years; 158 (60.8%) were male. Mean hospital stay was 7 ± 2.6 days. The decision of discharging was taken considering clinical and laboratory findings. On discharge, no patients had fever or hemorrhage. The patients were followed-up clinically and a repeat CCHF PCR was not studied. All centers considered the following criteria for discharge: no fever and hemorrhage, improvement in clinical findings and laboratory studies. For all patients except one, platelet count was >50,000/mm3 and had a tendency to increase. Prothrombin time and international normalized ratio (INR) were normal in 258 (99.6%) and 254 (98.1%) patients respectively. Alanine aminotransferase (ALT) was either normal or not higher than 10-fold and had a tendency to decrease in 259 (99.6%) patients. ALT and aspartate aminotransferase (AST) levels were not taken as discharge criteria with priority. During 30 days following the discharge, complication, relapse, or secondary transmission were not reported. Conclusions The discharging practice of the centers based on clinical and laboratory parameters seems safe considering no complications, relapses, or secondary infection thereafter. Current discharge practice of the centers composed of no fever and hemorrhage, improvement in clinical findings, platelet count of either >100,000/mm3 or >50,000/mm3 with a tendency to increase, and normal bleeding tests can be used as the criteria of discharge.
KW - Crimean-Congo Hemorrhagic Fever
KW - Discharge disposition
KW - Reported outcomes
U2 - 10.1016/j.antiviral.2016.07.010
DO - 10.1016/j.antiviral.2016.07.010
M3 - Article
SN - 0166-3542
VL - 133
SP - 9
EP - 13
JO - Antiviral Research
JF - Antiviral Research
ER -