{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T18:08:01Z","timestamp":1775498881270,"version":"3.50.1"},"reference-count":19,"publisher":"Scientific Scholar","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,6]]},"abstract":"\n Background & objectives:<\/jats:title>\n Scrub typhus is a rickettsial infection seen along the Asian-Pacific rim and imposes a considerable burden on affected people in low- and middle-income countries. The present study was aimed to determine the direct cost of hospitalization of scrub typhus and its trend over six years.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This was a retrospective, observational, hospital based study of individuals admitted to the hospital, diagnosed with scrub typhus over six years, from January 2013 to December 2018. The potential out of pocket expenditure was evaluated.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n A total of 198 patients were included in the study. The median cost of admission (adjusted to INR 2020) for the six years (2013 to 2018) was found to be \n \n \n \n JOURNAL\/ijmer\/04.03\/02223309-202306000-00010\/559FF03\/v\/2023-09-02T030054Z\/r\/image-tiff\n \n \n \n 37,026 (US $ 490) [interquartile range (IQR) 22,996-64,992]. The median cost for patients admitted to the intensive care unit (ICU) was \n \n \n \n JOURNAL\/ijmer\/04.03\/02223309-202306000-00010\/559FF03\/v\/2023-09-02T030054Z\/r\/image-tiff\n \n \n \n 128,046 (US $ 1695) (IQR 71,575-201,171), while the cost for patients admitted to the ward-alone was \n \n \n \n JOURNAL\/ijmer\/04.03\/02223309-202306000-00010\/559FF03\/v\/2023-09-02T030054Z\/r\/image-tiff\n \n \n \n 33,232 (US $ 440) (IQR 19,609-45,373). The multivariable analysis showed that ARDS and SOFA score were the independent predictors of ICU admission.<\/jats:p>\n <\/jats:sec>\n \n Interpretation & conclusions:<\/jats:title>\n Hospitalisation for scrub typhus is associated with a substantial healthcare expense. The predictors of increased cost were the presence of acute respiratory distress syndrome (ARDS), shock, increasing sequential organ failure assessment (SOFA) score and duration of hospital stay.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijmr.ijmr_3917_20","type":"journal-article","created":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T04:40:04Z","timestamp":1688532004000},"page":"559-567","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Costs & outcomes of hospitalized scrub typhus infection in a tertiary hospital in south India"],"prefix":"10.25259","volume":"157","author":[{"given":"Kevin John","family":"John","sequence":"first","affiliation":[{"name":"Department of General Medicine, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarun K.","family":"George","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melvin","family":"Joy","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bimi","family":"John","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.C.","family":"Abraham","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmine","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2023,7,8]]},"reference":[{"key":"R1-20241212","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1097\/QCO.0000000000000664","article-title":"Scrub typhus:A reemerging infection","volume":"33","author":"John","year":"2020","journal-title":"Curr Opin Infect Dis"},{"key":"R2-20241212","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1089\/vbz.2016.1970","article-title":"Seroprevalence of scrub typhus infection in Arunachal Pradesh, India","volume":"16","author":"Jakharia","year":"2016","journal-title":"Vector Borne Zoonotic Dis"},{"key":"R5-20241212","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement:Guidelines for reporting observational studies","volume":"61","author":"von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"R6-20241212","doi-asserted-by":"crossref","first-page":"653","DOI":"10.2165\/11588380-000000000-00000","article-title":"Cost-of-illness studies:A guide to critical evaluation","volume":"29","author":"Larg","year":"2011","journal-title":"Pharmacoeconomics"},{"key":"R7-20241212","doi-asserted-by":"crossref","first-page":"327","DOI":"10.3350\/cmh.2014.20.4.327","article-title":"Cost-of-illness studies:Concepts, scopes, and methods","volume":"20","author":"Jo","year":"2014","journal-title":"Clin Mol Hepatol"},{"key":"R8-20241212","doi-asserted-by":"crossref","first-page":"26","DOI":"10.4103\/0022-3859.173193","article-title":"Analysis of sparse data in logistic regression in medical research:A newer approach","volume":"62","author":"Devika","year":"2016","journal-title":"J Postgrad Med"},{"key":"R9-20241212","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1080\/00401706.1962.10490038","article-title":"Transformation of the independent variables","volume":"4","author":"Box","year":"1962","journal-title":"Technometrics"},{"key":"R12-20241212","doi-asserted-by":"crossref","first-page":"e0196106","DOI":"10.1371\/journal.pone.0196106","article-title":"Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India:Do Indian households face distress health financing?","volume":"13","author":"Kastor","year":"2018","journal-title":"PLoS One"},{"key":"R13-20241212","doi-asserted-by":"crossref","first-page":"76","DOI":"10.4103\/0971-5916.193292","article-title":"Epidemiology &risk factors of scrub typhus in south India","volume":"144","author":"Varghese","year":"2016","journal-title":"Indian J Med Res"},{"key":"R14-20241212","doi-asserted-by":"crossref","first-page":"e0006062","DOI":"10.1371\/journal.pntd.0006062","article-title":"A review of the global epidemiology of scrub typhus","volume":"11","author":"Xu","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"R15-20241212","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1111\/tmi.12853","article-title":"Prevalence and risk factors for scrub typhus in South India","volume":"22","author":"Trowbridge","year":"2017","journal-title":"Trop Med Int Health"},{"key":"R16-20241212","doi-asserted-by":"crossref","first-page":"244","DOI":"10.5492\/wjccm.v4.i3.244","article-title":"Severe scrub typhus infection:Clinical features, diagnostic challenges and management","volume":"4","author":"Peter","year":"2015","journal-title":"World J Crit Care Med"},{"key":"R17-20241212","doi-asserted-by":"crossref","first-page":"e0006330","DOI":"10.1371\/journal.pntd.0006330","article-title":"Scrub typhus point-of-care testing:A systematic review and meta-analysis","volume":"12","author":"Saraswati","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"R18-20241212","first-page":"CD002150","article-title":"Antibiotics for treating scrub typhus","volume":"9","author":"El Sayed","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"R19-20241212","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1186\/s13054-021-03736-w","article-title":"Initial antimicrobial management of sepsis","volume":"25","author":"Niederman","year":"2021","journal-title":"Crit Care"},{"key":"R20-20241212","doi-asserted-by":"crossref","first-page":"901","DOI":"10.4103\/ijmr.IJMR_1764_15","article-title":"Scrub typhus in Uttarakhand &adjoining Uttar Pradesh:Seasonality, clinical presentations &predictors of mortality","volume":"144","author":"Bhargava","year":"2016","journal-title":"Indian J Med Res"},{"key":"R21-20241212","doi-asserted-by":"crossref","first-page":"769","DOI":"10.4269\/ajtmh.16-0088","article-title":"Scrub typhus in Northeastern Thailand:Eschar distribution, abnormal electrocardiographic findings, and predictors of fatal outcome","volume":"95","author":"Thipmontree","year":"2016","journal-title":"Am J Trop Med Hyg"},{"key":"R22-20241212","doi-asserted-by":"crossref","first-page":"497","DOI":"10.4103\/0972-5229.138145","article-title":"Profile of organ dysfunction and predictors of mortality in severe scrub typhus infection requiring intensive care admission","volume":"18","author":"Griffith","year":"2014","journal-title":"Indian J Crit Care Med"},{"key":"R23-20241212","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1258\/td.2010.090452","article-title":"Scrub typhus:An unrecognized threat in South India - Clinical profile and predictors of mortality","volume":"40","author":"Chrispal","year":"2010","journal-title":"Trop Doct"}],"container-title":["Indian Journal of Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/ijmr.IJMR_3917_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T23:06:31Z","timestamp":1751497591000},"score":1,"resource":{"primary":{"URL":"https:\/\/ijmr.org.in\/costs-outcomes-of-hospitalized-scrub-typhus-infection-in-a-tertiary-hospital-in-south-india\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":19,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ijmr.ijmr_3917_20","relation":{},"ISSN":["0971-5916","0975-9174"],"issn-type":[{"value":"0971-5916","type":"print"},{"value":"0975-9174","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6]]},"assertion":[{"value":"2020-09-16","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}}]}}