A new perspective to determine the severity of cases with Crimean-Congo hemorrhagic fever

Background & objectives: We have established a severity grading score (SOS) system for predicting the fatality :in Crimean-Congo hemorrhagic fever (CCHF) for the first time. Methods: This SOS has been set up by using several variables which were assumed to be associated with mortality according to the literature and also were considered to have clinical importance. Results: In all, 237 patients who had symptoms of CCHF for <= 5 days were included. The patients were grouped into three categories according to the mortality risk by using SOS as follows : low or no risk, intermediate and high risk groups. A SOS <= 5 showed no association with mortality (there were 158 cases in this group and all survived). This group constituted 66.7% of all the patients with CCHF. A SOS 6-10 showed moderate risk of mortality (10%) and seven out of 70 patients in this group died. SOS >= 11 means high risk for mortality (67%) and six out of 9 patients in this group died (p = 0.001). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for >= 11 points of SOS were 67, 100, 98, 100, and 98%, respectively. Conclusions: This scoring system may help the clinicians to decide which patient to refer to a tertiary step hospital which may also decrease the cost and improve the functionality of healthcare staff.