Table 2.
Haematology and ROTEM data at admission (<48 h) by severity of Crimean–Congo haemorrhagic fever
| All patients (n=45) | Patients with mild disease (n=31) | Patients with moderate to severe disease (n=14) | p value | ||
|---|---|---|---|---|---|
| Haematology variables | |||||
| Platelets, × 109 cells per L (range; IQR) | 73 (4–162; 55–113) | 90 (46–166; 71–125) | 46 (4–108; 29–66) | <0·0001 | |
| White blood cells, × 109 cells per L (range; IQR) | 2·4 (0·74–28·3; 1·53–3·35) | 2·35 (0·74–5·31; 1·48–3·11) | 2·45 (0·85–28·3; 1·52–3·70) | 0·74 | |
| Prothrombin time, s* | 14·0 (4·4) | 13·1 (2·1) | 15·8 (7·0) | 0·08 | |
| Activated partial thromboplastin time, s* | 38·3 (13·8) | 32·8 (6·7) | 49·9 (17·8) | <0·0001 | |
| Haemoglobin, g/dL | 13·5 (2·1) | 13·8 (1·8) | 12·7 (2·6) | 0·10 | |
| ROTEM (EXTEM S) variables | |||||
| Clotting time, s | |||||
| Median (range; IQR) | 59 (42–164; 49–69) | 56 (42–81; 48–64) | 69 (48–164; 54–75) | 0·01 | |
| 38–79 s | 42 | 30 | 12 | .. | |
| >79 s | 3 | 1 | 2 | .. | |
| Amplitude at 10 min, mm | |||||
| Mean (SD) | 41·6 (9·1) | 45·1 (7·0) | 33·9 (8·6) | <0·0001 | |
| 43–65 mm | 19 | 17 | 2 | .. | |
| <43 mm | 26 | 14 | 12 | .. | |
| Clot formation time, s | |||||
| Median (range; IQR) | 165 (72–418; 130–201) | 147 (72–255; 109–171) | 197 (98–418; 156–296) | 0·006 | |
| 34–159 s (normal range) | 20 | 16 | 4 | .. | |
| 160–220 s (usually unimpaired haemostasis with reduced n reserve) | 17 | 13 | 4 | .. | |
| 221–300 s (bleeding risk) | 6 | 2 | 4 | .. | |
| 301–400 s (high bleeding risk) | 0 | 0 | 0 | .. | |
| >400 s (usually no effective haemostasis) | 2 | 0 | 2 | .. | |
| Maximum clot firmness, mm | |||||
| Mean (SD) | 51·5 (10·1) | 54·4 (7·2) | 45·1 (12·5) | 0·003 | |
| ≥50 mm (normal range) | 24 | 21 | 3 | .. | |
| 46–49 mm (usually unimpaired haemostasis with reduced n reserve) | 12 | 7 | 5 | .. | |
| 40–45 mm (bleeding risk) | 6 | 3 | 3 | .. | |
| 30–39 mm (high bleeding risk) | 2 | 0 | 2 | .. | |
| <30 mm (usually no effective haemostasis) | 1 | 0 | 1 | .. | |
| Lysis index at 60 min >15% | 0 | 0 | 0 | NA | |
| ROTEM (FIBTEM S) variables | |||||
| Amplitude at 10 min, mm | |||||
| Median (range; IQR) | 13 (6–25; 10–15) | 13 (8–20; 11–15) | 12 (6–25; 10–15) | 0·68 | |
| 7–23 mm | 42 | 29 | 13 | .. | |
| <7 mm | 1 | 0 | 1 | .. | |
| Maximum clot firmness, mm | |||||
| Median (range; IQR) | 15 (7–60; 13–21) | 15 (9–60; 13–21) | 17 (7–39; 13–23) | 0·21 | |
| 9–25 mm | 41 | 29 | 12 | .. | |
| <9 mm | 2 | 0 | 2 | .. | |
Data are n, mean (SD), or median (range; IQR). NA=not available. ROTEM=rotational thromboelastometry. EXTEM S=extrinsically activated ROTEM. FIBTEM S=fibrin-specific ROTEM.
*
28 patients in mild group and 13 in moderate to severe group.