Modified Glasgow prognostic score and APRI predict ICU admission in Crimean-Congo hemorrhagic fever.

BACKGROUND

This study aimed to evaluate the prognostic value of the Modified Glasgow Prognostic Score (mGPS) and the aspartate aminotransferase to platelet ratio index (APRI) in predicting intensive care unit (ICU) requirement among patients diagnosed with Crimean-Congo hemorrhagic fever (CCHF).

METHODS

Data from 181 patients diagnosed with CCHF between January 2023 and January 2026 were retrospectively analyzed. Demographic characteristics, laboratory parameters, and clinical outcomes were recorded. mGPS and APRI scores were calculated, and their associations with ICU requirement were evaluated using receiver operating characteristic (ROC) curve analysis and logistic regression models. Model fit was assessed with the Hosmer-Lemeshow test.

RESULTS

Univariate analysis revealed significant associations between intensive care unit (ICU) requirement and variables including age, aspartate aminotransferase (AST), C-reactive protein (CRP), alanine aminotransferase (ALT), international normalized ratio (INR), blood urea nitrogen (BUN), platelet count, Modified Glasgow Prognostic Score (mGPS), and Aspartate Aminotransferase-to-Platelet Ratio Index (APRI). In multivariate analysis, patients with an mGPS score of 2 had a 10.04-fold higher likelihood of ICU admission compared to those with an mGPS of 0 (OR=10.041; 95% CI: 1.187-84.936; p = 0.034). Each unit increase in APRI was associated with a 3.9% increase in ICU risk (OR=1.039; 95% CI: 1.002-1.078; p = 0.040). ROC analysis demonstrated the highest discriminative power for mGPS (AUC=0.738), followed by APRI (AUC=0.715) and CRP (AUC=0.699). The optimal APRI cut-off was 11.5, yielding 85% sensitivity and 72% specificity.

CONCLUSION

mGPS and APRI were identified as independent and significant prognostic indicators of ICU requirement in patients with CCHF. Their simple and practical structure supports their use in early risk stratification, especially in clinical settings where rapid prognostic assessment is critical.