Association of scrub typhus with the risk of venous thromboembolism and long-term mortality: a population-based cohort study.

Publisher: Springer Country of Publication: Germany NLM ID: 8804297 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1435-4373 (Electronic) Linking ISSN: 09349723 NLM ISO Abbreviation: Eur J Clin Microbiol Infect Dis Subsets: MEDLINE

Publication: Berlin : Springer
Original Publication: [Wiesbaden, Federal Republic of Germany] : Vieweg, [c1988-

Scrub Typhus*/complications ; Scrub Typhus*/epidemiology ; Scrub Typhus*/mortality ; Venous Thromboembolism*/epidemiology ; Venous Thromboembolism*/mortality ; Venous Thromboembolism*/etiology; Humans ; Male ; Female ; Middle Aged ; Aged ; Adult ; Risk Factors ; Cohort Studies ; Proportional Hazards Models ; Aged, 80 and over ; Pulmonary Embolism/mortality ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/etiology ; Young Adult

Background: The existing literature lacks studies examining the epidemiological link between scrub typhus and deep vein thrombosis (DVT) or pulmonary embolism (PE), and the long-term outcomes. The objective of this study is to explore the potential association between scrub typhus and the subsequent risk of venous thromboembolism, and long-term mortality.
Method: This nationwide cohort study identified 10,121 patients who were newly diagnosed with scrub typhus. Patients with a prior DVT or PE diagnosis before the scrub typhus infection were excluded. A comparison cohort of 101,210 patients was established from the general population using a propensity score matching technique. The cumulative survival HRs for the two cohorts were calculated by the Cox proportional hazards model.
Result: After adjusting for sex, age, and comorbidities, the scrub typhus group had an adjusted HR (95% CI) of 1.02 (0.80-1.30) for DVT, 1.11 (0.63-1.93) for PE, and 1.16 (1.08-1.25) for mortality compared to the control group. The post hoc subgroup analysis revealed that individuals younger than 55 years with a prior scrub typhus infection had a significantly higher risk of DVT (HR: 1.59; 95% CI: 1.12-2.25) and long-term mortality (HR: 1.75; 95% CI, 1.54-1.99).
Conclusion: The scrub typhus patients showed a 16% higher risk of long-term mortality. For those in scrub typhus cohort below 55 years of age, the risk of developing DVT was 1.59 times higher, and the risk of mortality was 1.75 times higher. Age acted as an effect modifier influencing the relationship between scrub typhus and risk of new-onset DVT and death.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

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CMU111-MF-105 China Medical University; MOST 109-2410-H-039-002, MOST 110-2410-H-039-002, MOST 111-2410-H-039-002-MY3 Ministry of Science and Technology, Taiwan

Keywords: Deep vein thrombosis; Mortality; Prognosis; Pulmonary embolism; Scrub typhus; Venous thromboembolism

Date Created: 20240313 Date Completed: 20240521 Latest Revision: 20240521

20240521

10.1007/s10096-024-04793-z

38472518