title: Multi-center prospective evaluation of discharge criteria for hospitalized patients with Crimean-Congo Hemorrhagic Fever.
abstract: 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.
  
  
  
  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.
  
  
  
  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/mm(3) 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.
  
  
  
  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/mm(3) or >50,000/mm(3) with a tendency to increase, and normal bleeding tests can be used as the criteria of discharge.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Samsun, Turkey. Electronic address: hakanomu@yahoo.com.
authors.forename: Hakan
authors.initials: H
authors.lastname: Leblebicioglu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Samsun, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sunbul
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpasa University Medical School, Tokat, Turkey.
authors.forename: Sener
authors.initials: S
authors.lastname: Barut
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University Medical School, Sivas, Turkey.
authors.forename: Seyit Ali
authors.initials: SA
authors.lastname: Buyuktuna
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ataturk University Medical School, Erzurum, Turkey.
authors.forename: Zulal
authors.initials: Z
authors.lastname: Ozkurt
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Hitit University Medical School, Corum, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Yapar
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Medical School, Samsun, Turkey.
authors.forename: Gurdal
authors.initials: G
authors.lastname: Yilmaz
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University Medical School, Ankara, Turkey.
authors.forename: Rahmet
authors.initials: R
authors.lastname: Guner
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: But
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
authors.forename: Gonul
authors.initials: G
authors.lastname: Cicek Senturk
authors.affiliation: Department of Industrial Engineering, Ondokuz Mayis University, Faculty of Engineering, Samsun, Turkey.
authors.forename: Naci
authors.initials: N
authors.lastname: Murat
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey.
authors.forename: Resat
authors.initials: R
authors.lastname: Ozaras
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D000066491:Clinical Decision-Making; D005260:Female; D003225:Hemorrhagic Fever Virus, Crimean-Congo; D006479:Hemorrhagic Fever, Crimean / Q000175:diagnosis / Q000453:epidemiology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000592:standards; D011159:Population Surveillance
chemical_list: D015415:Biomarkers
keywords: Crimean-Congo Hemorrhagic Fever; Discharge disposition; Reported outcomes