Multi-inflammatory index as a novel predictive and prognostic marker in patients with Crimean–Congo haemorrhagic fever

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BACKGROUND: Crimean-Congo haemorrhagic fever (CCHF) is a severe tick-borne viral infection with a high mortality rate. The multi-inflammatory index (MII), consisting of MII-1, MII-2 and MII-3, has been proposed as a prognostic biomarker in infectious diseases. However, its role in CCHF prognosis remains unclear. METHODS: This retrospective observational study analysed 290 CCHF patients admitted to Erzurum Regional Training and Research Hospital between January 2019 and September 2024. The MIIs were calculated from blood samples obtained on the day of hospital admission. Patients were categorized based on mortality outcomes, and logistic regression and receiver operating characteristics curve analyses were conducted to assess the predictive value of the MIIs. RESULTS: Mortality occurred in 9.31% of patients, with significantly higher MII-1, MII-2 and MII-3 levels in non-survivors. MII-1 showed the highest predictive accuracy (area under the curve 0.846, sensitivity 88%, specificity 75%). No significant difference was found in ribavirin administration between survivors and non-survivors. CONCLUSIONS: MIIs, particularly MII-1, serve as independent predictors of mortality in CCHF patients. Early evaluation of MII levels may aid risk stratification and clinical decision-making. Future studies should explore the dynamic changes in these indices and their impact on treatment outcomes.

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