Predictors of Disease Severity and Adverse Outcomes in Patients with Scrub Typhus: A Retrospective Observational Study

Abstract

Aim: Scrub typhus is an important cause of acute febrile illness in endemic regions and can progress to multiorgan dysfunction, shock, and death. This retrospective study was designed to identify clinical and laboratory predictors of disease severity and adverse outcomes among hospitalized scrub typhus patients.

Materials and Methods: Records of patients with confirmed scrub typhus were reviewed retrospectively. Demographic variables, presenting symptoms, vital signs, and laboratory parameters were compared between nonsevere and severe disease groups, and between survivors and nonsurvivors. Predictors of adverse outcome were identified using univariate analysis followed by multivariable logistic regression, consistent with prior prognostic scrub typhus studies.

Results: Severe disease and mortality were associated with older age, tachycardia, respiratory findings such as crepitations and dyspnea, thrombocytopenia, elevated transaminases, hypoalbuminemia, hyperbilirubinemia, and renal dysfunction. Prior studies have repeatedly shown serum creatinine, albumin, AST, and clinical evidence of pulmonary involvement to be strong predictors of severity and death.

Conclusion: Scrub typhus severity is largely determined by early organ dysfunction, especially hepatic, renal, and respiratory involvement. A simple admission-based risk profile using age, pulse rate, chest findings, AST, albumin, and creatinine may help clinicians triage high-risk patients and intensify monitoring early.

Keywords: Scrub typhus; severity; mortality; predictors; multiorgan dysfuncti