Patient selection: scrub typhus (Orientia tsutsugamushi)
Mortality risk factors from multivariate analysis:
(1) absence of an eschar
(2) admission to the ICU
(3) higher APACHE II score
where:
• Fatal cases showed a mean APACHE II score 16.9 with standard deviation 6.2. Non-fatal cases had a mean score of 8.3 with a standard deviation of 4.8. An APACHE II score >= 14 will be used in the implementation as indicating risk.
Additional findings associated with a fatal outcome:
(1) septic shock on hospital admission
(2) low serum albumin (<= 3.0 g/dL)
(3) leukocytosis (will use >= 14,000 per µL in the implementation)
(4) one or more organ failure (acute renal failure, coma, respiratory failure, acute hepatic failure, myocarditis)