{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T13:45:45Z","timestamp":1778247945236,"version":"3.51.4"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Nanjing Second Hospital Reserve Talent Program","award":["0316301"],"award-info":[{"award-number":["0316301"]}]},{"name":"Jiangsu Provincial Health and Health Commission 2021 Medical Research Projects","award":["Jiangsu Health Science and Education (2021) No. 149"],"award-info":[{"award-number":["Jiangsu Health Science and Education (2021) No. 149"]}]},{"name":"2021 Nanjing Health Science and Technology Development Special Funds Project","award":["YKK21121"],"award-info":[{"award-number":["YKK21121"]}]},{"name":"Postgraduate Research & Practice Innovation Program of Jiangsu Province","award":["SJCX23_0856"],"award-info":[{"award-number":["SJCX23_0856"]}]},{"name":"Nanjing Infectious Disease Clinical Medical Center; Innovation center for infectious disease of Jiangsu Province","award":["NO.CXZX202232"],"award-info":[{"award-number":["NO.CXZX202232"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Several scoring systems have been proposed to predict the risk of death due to severe fever with thrombocytopenia syndrome (STFS), but they have limitations. We developed a new prognostic nomogram for STFS-related death and compared its performance with previous scoring systems and the Acute Physiology and Chronic Health Evaluation score (APACHE II Score).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A total of 292 STFS patients were retrospectively enrolled between January 2016 and March 2023. Boruta\u2019s algorithm and backward stepwise regression were used to select variables for constructing the nomogram. Time-dependent receiver operating characteristic (ROC) curves and clinical decision curves were generated to compare the strengths of the nomogram with others.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Age, Sequential Organ Failure Assessment Score (SOFA score), state of consciousness, continuous renal replacement therapy (CRRT), and D-dimer were significantly correlated with mortality in both univariate and multivariate analyses (P&lt;0.05). We developed a nomogram using these variables to predict mortality risk, which outperformed the SFTS and APACHE II scores (Training ROC: 0.929 vs. 0.848 vs. 0.792; Validation ROC: 0.938 vs. 0.839 vs. 0.851; P&lt;0.001). In the validation set, the SFTS model achieved an accuracy of 76.14%, a sensitivity of 95.31%, a specificity of 25.00%, a precision of 77.22%, and an F1 score of 85.32%. The nomogram showed a superior performance with an accuracy of 86.36%, a precision of 88.24%, a recall of 93.75%, and an F1 score of 90.91%.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Age, consciousness, SOFA Score, CRRT, and D-Dimer are independent risk factors for STFS-related death. The nomogram based on these factors has an excellent performance in predicting STFS-related death and is recommended for clinical practice.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0311924","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T17:42:07Z","timestamp":1729791727000},"page":"e0311924","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Establishment and validation of a prognostic nomogram for severe fever with thrombocytopenia syndrome: A retrospective observational study"],"prefix":"10.1371","volume":"19","author":[{"given":"Kai","family":"Yang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiepeng","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingyan","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongyang","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daguang","family":"Cui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tongyue","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6701-8354","authenticated-orcid":true,"given":"Yishan","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,10,24]]},"reference":[{"issue":"7","key":"pone.0311924.ref001","article-title":"Clinical Update of Severe Fever with Thrombocytopenia Syndrome","volume":"13","author":"JW Seo","year":"2021","journal-title":"Viruses"},{"issue":"16","key":"pone.0311924.ref002","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1056\/NEJMoa1010095","article-title":"Fever with thrombocytopenia associated with a novel bunyavirus in China","volume":"364","author":"XJ Yu","year":"2011","journal-title":"N Engl J Med"},{"issue":"6","key":"pone.0311924.ref003","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.4269\/ajtmh.16-0333","article-title":"Severe Fever with Thrombocytopenia Syndrome Virus in Humans, Domesticated Animals, Ticks, and Mosquitoes, Shaanxi Province, China","volume":"96","author":"H Tian","year":"2017","journal-title":"Am J Trop Med Hyg"},{"key":"pone.0311924.ref004","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.ijid.2022.08.008","article-title":"Human-to-human transmission of severe fever with thrombocytopenia syndrome virus through potential ocular exposure to infectious blood","volume":"123","author":"YX Wu","year":"2022","journal-title":"Int J Infect Dis"},{"issue":"6","key":"pone.0311924.ref005","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1093\/infdis\/jit603","article-title":"The first identification and retrospective study of Severe Fever with Thrombocytopenia Syndrome in Japan","volume":"209","author":"T Takahashi","year":"2014","journal-title":"J Infect Dis"},{"issue":"1","key":"pone.0311924.ref006","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1080\/22221751.2019.1710436","article-title":"The first discovery of severe fever with thrombocytopenia syndrome virus in Taiwan","volume":"9","author":"TL Lin","year":"2020","journal-title":"Emerging microbes & infections"},{"issue":"5","key":"pone.0311924.ref007","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.3201\/eid2505.181463","article-title":"Endemic Severe Fever with Thrombocytopenia Syndrome, Vietnam","volume":"25","author":"XC Tran","year":"2019","journal-title":"Emerg Infect Dis"},{"issue":"12","key":"pone.0311924.ref008","first-page":"2226","article-title":"A review on the epidemiology of severe fever with thrombocytopenia syndrome","volume":"42","author":"JC Li","year":"2021","journal-title":"Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi"},{"issue":"1","key":"pone.0311924.ref009","article-title":"Prognostic Factors of Severe Fever with Thrombocytopenia Syndrome in South Korea","volume":"13","author":"M Kim","year":"2020","journal-title":"Viruses"},{"issue":"8","key":"pone.0311924.ref010","doi-asserted-by":"crossref","first-page":"e0009687","DOI":"10.1371\/journal.pntd.0009687","article-title":"Seroepidemiologic survey of emerging vector-borne infections in South Korean forest\/field workers","volume":"15","author":"JY Noh","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pone.0311924.ref011","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1186\/s12985-024-02403-0","article-title":"Cytokines and lymphocyte subsets are associated with disease severity of severe fever with thrombocytopenia syndrome","volume":"21","author":"L Song","year":"2024","journal-title":"Virol J"},{"issue":"1","key":"pone.0311924.ref012","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1038\/s41598-017-18616-z","article-title":"The Regulation of Seventeen Inflammatory Mediators are Associated with Patient Outcomes in Severe Fever with Thrombocytopenia Syndrome","volume":"8","author":"LF Hu","year":"2018","journal-title":"Sci Rep"},{"issue":"6","key":"pone.0311924.ref013","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18063092","article-title":"Epidemiological Characteristics of Severe Fever with Thrombocytopenia Syndrome from 2010 to 2019 in Mainland China","volume":"18","author":"X Huang","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"52","key":"pone.0311924.ref014","doi-asserted-by":"crossref","first-page":"e5708","DOI":"10.1097\/MD.0000000000005708","article-title":"A simple and practical score model for predicting the mortality of severe fever with thrombocytopenia syndrome patients","volume":"95","author":"S Xiong","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"11","key":"pone.0311924.ref015","doi-asserted-by":"crossref","first-page":"e0007829","DOI":"10.1371\/journal.pntd.0007829","article-title":"A nomogram to predict mortality in patients with severe fever with thrombocytopenia syndrome at the early stage-A multicenter study in China","volume":"13","author":"L Wang","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"issue":"9","key":"pone.0311924.ref016","doi-asserted-by":"crossref","first-page":"e0005909","DOI":"10.1371\/journal.pntd.0005909","article-title":"A scoring model for predicting prognosis of patients with severe fever with thrombocytopenia syndrome","volume":"11","author":"B Jia","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pone.0311924.ref017","doi-asserted-by":"crossref","first-page":"94","DOI":"10.4269\/ajtmh.22-0667","article-title":"Risk Factors for Death in Patients with Severe Fever with Thrombocytopenia Syndrome","volume":"109","author":"K Yang","year":"2023","journal-title":"Am J Trop Med Hyg"},{"issue":"3","key":"pone.0311924.ref018","doi-asserted-by":"crossref","first-page":"261","DOI":"10.3184\/003685018X15295002645082","article-title":"Occam\u2019s razor: from Ockham\u2019s via moderna to modern data science","volume":"101","author":"HA Van Den Berg","year":"2018","journal-title":"Sci Prog"},{"issue":"7","key":"pone.0311924.ref019","doi-asserted-by":"crossref","first-page":"e048008","DOI":"10.1136\/bmjopen-2020-048008","article-title":"Protocol for development of a reporting guideline (TRIPOD-AI) and risk of bias tool (PROBAST-AI) for diagnostic and prognostic prediction model studies based on artificial intelligence","volume":"11","author":"GS Collins","year":"2021","journal-title":"BMJ open"},{"issue":"11","key":"pone.0311924.ref020","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v036.i11","article-title":"Feature Selection with the Boruta Package","volume":"36","author":"MB Kursa","year":"2010","journal-title":"Journal of Statistical Software"},{"issue":"1","key":"pone.0311924.ref021","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s40168-020-00836-7","article-title":"Cultivation-independent and cultivation-dependent metagenomes reveal genetic and enzymatic potential of microbial community involved in the degradation of a complex microbial polymer","volume":"8","author":"OYA Costa","year":"2020","journal-title":"Microbiome"},{"issue":"4","key":"pone.0311924.ref022","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.4269\/ajtmh.20-0270","article-title":"Clinical Progress and Risk Factors for Death from Severe Fever with Thrombocytopenia Syndrome: A Multihospital Retrospective Investigation in Anhui, China","volume":"104","author":"L Gong","year":"2021","journal-title":"Am J Trop Med Hyg"},{"issue":"4","key":"pone.0311924.ref023","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19042271","article-title":"Clinical Presentation and Mortality of Severe Fever with Thrombocytopenia Syndrome in Japan: A Systematic Review of Case Reports","volume":"19","author":"K Yokomizo","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pone.0311924.ref024","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s40249-022-01017-4","article-title":"Transmission and mortality risk assessment of severe fever with thrombocytopenia syndrome in China: results from 11-years\u2019 study","volume":"11","author":"Q Chen","year":"2022","journal-title":"Infectious diseases of poverty"},{"key":"pone.0311924.ref025","doi-asserted-by":"crossref","first-page":"1076226","DOI":"10.3389\/fpubh.2023.1076226","article-title":"Analysis of fatal cases of severe fever with thrombocytopenia syndrome in Jiangsu province, China, between 2011 and 2022: A retrospective study","volume":"11","author":"S Liang","year":"2023","journal-title":"Frontiers in public health"},{"issue":"7","key":"pone.0311924.ref026","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1093\/infdis\/jis472","article-title":"Clinical progress and risk factors for death in severe fever with thrombocytopenia syndrome patients","volume":"206","author":"ZT Gai","year":"2012","journal-title":"J Infect Dis"},{"issue":"8","key":"pone.0311924.ref027","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1001\/jama.2016.0288","article-title":"Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"CW Seymour","year":"2016","journal-title":"JAMA"},{"issue":"1","key":"pone.0311924.ref028","doi-asserted-by":"crossref","first-page":"40","DOI":"10.5152\/eurasianjmed.2021.20081","article-title":"Comparison of SOFA Score, SIRS, qSOFA, and qSOFA + L Criteria in the Diagnosis and Prognosis of Sepsis","volume":"53","author":"A Kilinc Toker","year":"2021","journal-title":"The Eurasian journal of medicine"},{"issue":"1","key":"pone.0311924.ref029","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1186\/s12879-022-07705-8","article-title":"A modified Sequential Organ Failure Assessment score for dengue: development, evaluation and proposal for use in clinical trials","volume":"22","author":"A McBride","year":"2022","journal-title":"BMC Infect Dis"},{"issue":"14","key":"pone.0311924.ref030","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1001\/jama.2021.1545","article-title":"Discriminant Accuracy of the SOFA Score for Determining the Probable Mortality of Patients With COVID-19 Pneumonia Requiring Mechanical Ventilation","volume":"325","author":"RA Raschke","year":"2021","journal-title":"JAMA"},{"issue":"10","key":"pone.0311924.ref031","doi-asserted-by":"crossref","first-page":"e0223457","DOI":"10.1371\/journal.pone.0223457","article-title":"Utility of qSOFA and modified SOFA in severe malaria presenting as sepsis","volume":"14","author":"P Teparrukkul","year":"2019","journal-title":"PLoS One"},{"key":"pone.0311924.ref032","first-page":"1","article-title":"Research Progress of Fever with Thrombocytopenia Syndrome","author":"N Luo","year":"2023","journal-title":"Intensive care research"},{"issue":"1","key":"pone.0311924.ref033","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1186\/s13054-019-2665-5","article-title":"The early change of SOFA score as a prognostic marker of 28-day sepsis mortality: analysis through a derivation and a validation cohort","volume":"23","author":"E Karakike","year":"2019","journal-title":"Crit Care"},{"issue":"1","key":"pone.0311924.ref034","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1186\/s12879-021-06627-1","article-title":"Clinical feature of severe fever with thrombocytopenia syndrome (SFTS)-associated encephalitis\/encephalopathy: a retrospective study","volume":"21","author":"Y Xu","year":"2021","journal-title":"BMC Infect Dis"},{"issue":"10","key":"pone.0311924.ref035","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/S1473-3099(18)30293-7","article-title":"Epidemiological and clinical features of laboratory-diagnosed severe fever with thrombocytopenia syndrome in China, 2011\u201317: a prospective observational study","volume":"18","author":"H Li","year":"2018","journal-title":"Lancet Infect Dis"},{"issue":"6","key":"pone.0311924.ref036","doi-asserted-by":"crossref","first-page":"3960","DOI":"10.1002\/jmv.26518","article-title":"Clinical manifestations of death with severe fever and thrombocytopenia syndrome: A meta-analysis and systematic review","volume":"93","author":"X Wang","year":"2021","journal-title":"J Med Virol"},{"issue":"1","key":"pone.0311924.ref037","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.jinf.2014.08.001","article-title":"Severe fever with thrombocytopenia syndrome bunyavirus-related human encephalitis","volume":"70","author":"N Cui","year":"2015","journal-title":"J Infect"},{"issue":"1","key":"pone.0311924.ref038","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1186\/s12866-022-02609-8","article-title":"Severe fever with thrombocytopenia syndrome virus replicates in brain tissues and damages neurons in newborn mice","volume":"22","author":"R Chen","year":"2022","journal-title":"BMC Microbiol"},{"issue":"5","key":"pone.0311924.ref039","doi-asserted-by":"crossref","first-page":"e500","DOI":"10.1097\/CCM.0000000000004917","article-title":"d-dimer and Death in Critically Ill Patients With Coronavirus Disease 2019","volume":"49","author":"SAP Short","year":"2021","journal-title":"Crit Care Med"},{"issue":"7","key":"pone.0311924.ref040","first-page":"793","article-title":"Clinical features and significance of coagulation dysfunction in severe fever with thrombocytopenia syndrome","volume":"61","author":"L Xu","year":"2022","journal-title":"Zhonghua Nei Ke Za Zhi"},{"key":"pone.0311924.ref041","doi-asserted-by":"crossref","first-page":"1236091","DOI":"10.3389\/fmicb.2023.1236091","article-title":"Clinical characteristics and outcomes of acute kidney injury in patients with severe fever with thrombocytopenia syndrome","volume":"14","author":"Z Zhang","year":"2023","journal-title":"Front Microbiol"},{"issue":"6","key":"pone.0311924.ref042","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1111\/nicc.12401","article-title":"Acute Physiology and Chronic Health Evaluation II score for the assessment of mortality prediction in the intensive care unit: a single-centre study from Iran","volume":"24","author":"M Bahtouee","year":"2019","journal-title":"Nurs Crit Care"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0311924","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T17:43:06Z","timestamp":1729791786000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0311924"}},"subtitle":[],"editor":[{"given":"Elvan","family":"Wiyarta","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,10,24]]},"references-count":42,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0311924","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,24]]}}}