title: Clinical Predictors of Multiple Organ Dysfunction Syndromes in Pediatric patients with Scrub Typhus.
abstract: Scrub typhus can produce multiple organ dysfunction syndrome (MODS). Early recognition of the patients at risk of MODS would be helpful in providing timely management and reducing the mortality. In all, 449 children with scrub typhus were enrolled at three hospitals in Yunnan, China from January 2010 to January 2015. The patients' clinical status of organ system dysfunction was evaluated on the day of discharge from hospital by using standard criteria. The patients were classified into MODS present (64 cases, 14.3%) or MODS absent (385 cases, 85.7%). Multivariate logistic regression analyses revealed that the prognostic factors for MODS included skin rash (odds ratio, OR = 3.3, p = 0.037), time interval form treatment to defervescence (OR = 1.2, p = 0.035), hemoglobin (OR = 0.54, p = 0.041), platelet counts (OR = 0.06, p < 0.001), aspartate-aminotransferase (OR = 4.7, p = 0.011) and total bilirubin (OR = 2.3, p = 0.013). By describing risk factors resulting in MODS in pediatric scrub typhus, our study provides clinicians with important information to improve the clinical monitoring and prognostication of MODS.
authors.affiliation: Xin Hua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, 200092, China.
authors.forename: Dongying
authors.initials: D
authors.lastname: Zhao
authors.affiliation: Xin Hua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, 200092, China.|MOE and Shanghai Key Laboratory of Children's Environmental Health, Shanghai, 200092, China.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Dehong People's Hospital, Yunnan, 678400, China.
authors.forename: Zhaoqing
authors.initials: Z
authors.lastname: Yin
authors.affiliation: Longling People's Hospital, Yunnan, 678300, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Longling People's Hospital, Yunnan, 678300, China.
authors.forename: Defeng
authors.initials: D
authors.lastname: Yang
authors.affiliation: Baoshan People's Hospital, Yunnan, 678000, China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009102:Multiple Organ Failure / Q000453:epidemiology* / Q000209:etiology; D015999:Multivariate Analysis; D012285:Orientia tsutsugamushi / Q000302:isolation & purification*; D012111:Residence Characteristics; D012307:Risk Factors; D012612:Scrub Typhus / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D016896:Treatment Outcome
keywords: children.; clinical predictors; eschar scrub typhus; multiple organ dysfunction syndromes