Hakan Leblebicioglu1, Mustafa Sunbul2, Sener Barut3, Seyit Ali Buyuktuna4, Zulal Ozkurt5, Derya Yapar6, Gurdal Yilmaz7, Rahmet Guner8, Ayse But9, Gonul Cicek Senturk10, Naci Murat11, Resat Ozaras12. 1. Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Samsun, Turkey. Electronic address: hakanomu@yahoo.com. 2. Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Samsun, Turkey. 3. Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpasa University Medical School, Tokat, Turkey. 4. Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University Medical School, Sivas, Turkey. 5. Department of Infectious Diseases and Clinical Microbiology, Ataturk University Medical School, Erzurum, Turkey. 6. Department of Infectious Diseases and Clinical Microbiology, Hitit University Medical School, Corum, Turkey. 7. Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Medical School, Samsun, Turkey. 8. Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University Medical School, Ankara, Turkey. 9. Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey. 10. Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey. 11. Department of Industrial Engineering, Ondokuz Mayis University, Faculty of Engineering, Samsun, Turkey. 12. Department of Infectious Diseases and Clinical Microbiology, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey.
Abstract
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/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. 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/mm(3) or >50,000/mm(3) with a tendency to increase, and normal bleeding tests can be used as the criteria of discharge.
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/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. 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/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: Fernando de la Calle-Prieto; Alejandro Martín-Quirós; Elena Trigo; Marta Mora-Rillo; Marta Arsuaga; Marta Díaz-Menéndez; José Ramón Arribas Journal: Enferm Infecc Microbiol Clin (Engl Ed) Date: 2017-06-29