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已发表论文
中国大理地区肾综合征出血热 30 天预后的危险因素
Authors Huang L , Yan Q, Gao XM, Gu W
Received 14 July 2025
Accepted for publication 4 November 2025
Published 18 November 2025 Volume 2025:18 Pages 6007—6017
DOI https://doi.org/10.2147/IDR.S549717
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Chi H. Lee
Lihua Huang,1 Qiaolu Yan,2 Xiu Mei Gao,3 Wei Gu1
1Department of Infectious Diseases, The First Affiliated Hospital of Dali University, Dali, Yunnan, People’s Republic of China; 2Department of Pulmonary and Critical Care Medicine, People’s Hospital of Dali Bai Autonomous Prefecture, Dali, Yunnan, People’s Republic of China; 3Department of Infectious Diseases, Lijiang People’s Hospital, Lijiang, Yunnan, People’s Republic of China
Correspondence: Xiu Mei Gao, Department of Infectious Diseases, Lijiang People’s Hospital, No. 120 Meters North of the Intersection of Guanli 10 Road and Qingyun East Road, Gucheng District, Lijiang, Yunnan, 674100, People’s Republic of China, Email 1873536669@qq.com Wei Gu, Department of Infection Disease, The First Affiliated Hospital of Dali University, No. 32 Jia Shi Bo Road, Dali, Yunnan, 671000, People’s Republic of China, Email gw777@163.com
Objective: To analyze the risk factors for 30-day prognosis in patients with hemorrhagic fever with renal syndrome (HFRS) in the Dali region of China, and to provide a theoretical basis for the diagnosis and treatment of HFRS.
Methods: A retrospective analysis was conducted on the data of patients diagnosed with HFRS at the First Affiliated Hospital of Dali University and People’s Hospital of Dali Bai Autonomous Prefecture from January 1, 2015, to January 31, 2025. Based on the 30-day prognosis, patients were categorized into the survival group (n = 341) and the deceased group (n = 32). Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied to screen for influential factors affecting the 30-day prognosis of HFRS, followed by binary logistic regression analysis to identify risk factors for short-term prognosis of HFRS. Finally, a nomogram model was constructed based on the identified prognostic risk factors.
Results: A total of 373 patients with HFRS from the Dali region of China were included, with a 30-day mortality rate of 8.579%. LASSO-logistic regression analysis revealed that low levels of prothrombin time (PT), white blood cell (WBC), lactate dehydrogenase-to-albumin ratio (LAR), and free triiodothyronine (FT3) were risk factors for the 30-day prognosis of HFRS patients (P < 0.05). Based on these risk factors, a 30-day prognostic risk nomogram model for HFRS patients was constructed. The results indicated that the observed values in the nomogram model were largely consistent with the predicted values (χ2 = 2.834, P = 0.944), and the C-index was 0.946 (95% CI: 0.914– 0.978), demonstrating clinical validity. Monitoring these indicators is conducive to the early identification of HFRS patients with poor prognosis, providing a scientific basis for the implementation of individualized treatment and management in clinical practice.
Conclusion: PT, FT3, WBC levels, and LAR values are risk factors for 30-day mortality in patients with HFRS. Moreover, we have, for the first time, identified a close association between FT3 and LAR and the prognosis of HFRS. The developed nomogram demonstrates favorable predictive performance and can serve as an intuitive quantitative tool for the early identification of high-risk patients, thereby guiding clinical intervention strategies.
Keywords: hemorrhagic fever with renal syndrome, prognosis, risk factors, nomogram model
1Department of Infectious Diseases, The First Affiliated Hospital of Dali University, Dali, Yunnan, People’s Republic of China; 2Department of Pulmonary and Critical Care Medicine, People’s Hospital of Dali Bai Autonomous Prefecture, Dali, Yunnan, People’s Republic of China; 3Department of Infectious Diseases, Lijiang People’s Hospital, Lijiang, Yunnan, People’s Republic of China
Correspondence: Xiu Mei Gao, Department of Infectious Diseases, Lijiang People’s Hospital, No. 120 Meters North of the Intersection of Guanli 10 Road and Qingyun East Road, Gucheng District, Lijiang, Yunnan, 674100, People’s Republic of China, Email 1873536669@qq.com Wei Gu, Department of Infection Disease, The First Affiliated Hospital of Dali University, No. 32 Jia Shi Bo Road, Dali, Yunnan, 671000, People’s Republic of China, Email gw777@163.com
Objective: To analyze the risk factors for 30-day prognosis in patients with hemorrhagic fever with renal syndrome (HFRS) in the Dali region of China, and to provide a theoretical basis for the diagnosis and treatment of HFRS.
Methods: A retrospective analysis was conducted on the data of patients diagnosed with HFRS at the First Affiliated Hospital of Dali University and People’s Hospital of Dali Bai Autonomous Prefecture from January 1, 2015, to January 31, 2025. Based on the 30-day prognosis, patients were categorized into the survival group (n = 341) and the deceased group (n = 32). Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied to screen for influential factors affecting the 30-day prognosis of HFRS, followed by binary logistic regression analysis to identify risk factors for short-term prognosis of HFRS. Finally, a nomogram model was constructed based on the identified prognostic risk factors.
Results: A total of 373 patients with HFRS from the Dali region of China were included, with a 30-day mortality rate of 8.579%. LASSO-logistic regression analysis revealed that low levels of prothrombin time (PT), white blood cell (WBC), lactate dehydrogenase-to-albumin ratio (LAR), and free triiodothyronine (FT3) were risk factors for the 30-day prognosis of HFRS patients (P < 0.05). Based on these risk factors, a 30-day prognostic risk nomogram model for HFRS patients was constructed. The results indicated that the observed values in the nomogram model were largely consistent with the predicted values (χ2 = 2.834, P = 0.944), and the C-index was 0.946 (95% CI: 0.914– 0.978), demonstrating clinical validity. Monitoring these indicators is conducive to the early identification of HFRS patients with poor prognosis, providing a scientific basis for the implementation of individualized treatment and management in clinical practice.
Conclusion: PT, FT3, WBC levels, and LAR values are risk factors for 30-day mortality in patients with HFRS. Moreover, we have, for the first time, identified a close association between FT3 and LAR and the prognosis of HFRS. The developed nomogram demonstrates favorable predictive performance and can serve as an intuitive quantitative tool for the early identification of high-risk patients, thereby guiding clinical intervention strategies.
Keywords: hemorrhagic fever with renal syndrome, prognosis, risk factors, nomogram model