Coagulopathy parameters in patients with Crimean-Congo hemorrhagic fever and its relation with mortality.
BACKGROUND
Crimean-Congo hemorrhagic fever (CCHF) is an acute illness affecting multiple organ systems and characterized by ecchymosis, visceral bleeding, and hepatic dysfunction. In this study, we aimed to investigate the profile of coagulopathy markers (platelet count, activated partial tromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), fibrinogen, protein C, protein S, antithrombin III, activated protein C resistance (APCR), and D-dimer) and their clinical significance in 83 CCHF-infected patients.


METHODS
We studied 83 CCHF patients who were admitted to Ankara Numune Education and Research Hospital during the spring and summer of2007. We compared the coagulopathy markers of fatal CCHF patients (n=9) with nonfatal cases (n=74).


RESULTS
Platelet count, PT, aPTT, INR, and fibrinogen were prognostic factors associated with mortality for CCHF. Especially, platelet count<20 x 10(9) cells/l and aPTT>60 sec were important. Protein C, protein S, APCR, and antithrombin III levels were not associated with mortality.


CONCLUSIONS
Laboratory tests including classical parameters (platelet count, PT, aPTT, INR, and fibrinogen) of coagulopathy seem to be enough for the followup of CCHF. Protein S, protein C, APCR, and D-dimer levels were not associated with mortality.
Onguru
P
P
Department of Infectious Diseases and Clinical Microbiology, Numune Education and Research Hospital, Ankara, Turkey. pinaronguru1@yahoo.com
Dagdas
S
S
Bodur
H
H
Yilmaz
M
M
Akinci
E
E
Eren
S
S
Ozet
G
G
D020016:Activated Protein C Resistance / Q000175:diagnosis; D000990:Antithrombin III / Q000378:metabolism; D001779:Blood Coagulation Factors / Q000378:metabolism*; D001780:Blood Coagulation Tests; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006479:Hemorrhagic Fever, Crimean / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011379:Prognosis; D011486:Protein C / Q000378:metabolism; D017293:Protein S / Q000378:metabolism; D011517:Prothrombin Time; D012307:Risk Factors
D001779:Blood Coagulation Factors; D005338:Fibrin Fibrinogen Degradation Products; D011486:Protein C; D017293:Protein S; C036309:fibrin fragment D; D000990:Antithrombin III; D005340:Fibrinogen