The predictive value of red cell distribution width-to-albumin ratio combined with interferon-α and tumor necrosis factor-α for prognosis in patients with fever with thrombocytopenia syndrome

doi:10.19871/j.cnki.xfcrbzz.2026.03.009

Abstract

Abstract: Objective To evaluate the predictive value of the red cell distribution width-to-albumin ratio (RAR) combined with interferon-α(IFN-α) and tumor necrosis factor-α(TNF-α) for early identification of poor prognosis in patients with severe fever with thrombocytopenia syndrome (SFTS). Method A retrospective cohort study was conducted, enrolling 396 SFTS patients admitted to Nanjing Second Hospital between June 2023 and August 2025. Based on 28-day outcomes, patients were categorized into a cured group (n=304) and a poor prognosis group (n=92). Clinical data and laboratory parameters (including RAR, IFN-α, and TNF-α) collected at admission were analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. The predictive performance of individual indicators and a combined model was assessed using receiver operating characteristic (receiver operator characteristic curve, ROC) curve analysis. Result The poor prognosis group had significantly higher levels of age, RAR, viral load, TNF-α, IFN-α, total bilirubin (TBIL), glucose (GLU), and blood urea nitrogen (BUN) compared to the cured group (all P<0.05). Multivariate analysis confirmed these indicators as independent risk factors for poor prognosis (all P<0.05). ROC analysis showed that the areas under the curve (AUC) for RAR, TNF-α, and IFN-α alone were 0.762, 0.582, and 0.762, respectively. The AUC for the combined model increased to 0.864 (95%CI: 0.832-0.896), with a sensitivity of 72.8% and a specificity of 86.6%, demonstrating superior predictive performance compared to any single indicator. Conclusion RAR, IFN-α, and TNF-α are independent risk factors for poor prognosis in SFTS patients. The combined prediction model incorporating these three indicators shows good discriminative ability and may serve as a valuable tool for the early identification of high-risk patients, facilitating stratified clinical management.

Key words: Severe fever with thrombocytopenia syndrome, Red cell distribution width-to-albumin ratio, Interferon-α, Tumor necrosis factor-α, Prognosis

CLC Number:

R512.91
R373

Zhang Xuechen, Fang Mingxia, Jiang Hao, Lu Hu. The predictive value of red cell distribution width-to-albumin ratio combined with interferon-α and tumor necrosis factor-α for prognosis in patients with fever with thrombocytopenia syndrome[J]. Electronic Journal of Emerging Infectious Diseases, 2026, 11(3): 49-54.

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