Abstract
OBJECTIVE: To analyze the risk factors for 30-day prognosis in patients with hemorrhagic fever with renal syndrome (HFRS) in the Dali region of China, and to provide a theoretical basis for the diagnosis and treatment of HFRS. METHODS: A retrospective analysis was conducted on the data of patients diagnosed with HFRS at the First Affiliated Hospital of Dali University and People's Hospital of Dali Bai Autonomous Prefecture from January 1, 2015, to January 31, 2025. Based on the 30-day prognosis, patients were categorized into the survival group (n = 341) and the deceased group (n = 32). Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied to screen for influential factors affecting the 30-day prognosis of HFRS, followed by binary logistic regression analysis to identify risk factors for short-term prognosis of HFRS. Finally, a nomogram model was constructed based on the identified prognostic risk factors. RESULTS: A total of 373 patients with HFRS from the Dali region of China were included, with a 30-day mortality rate of 8.579%. LASSO-logistic regression analysis revealed that low levels of prothrombin time (PT), white blood cell (WBC), lactate dehydrogenase-to-albumin ratio (LAR), and free triiodothyronine (FT3) were risk factors for the 30-day prognosis of HFRS patients (P < 0.05). Based on these risk factors, a 30-day prognostic risk nomogram model for HFRS patients was constructed. The results indicated that the observed values in the nomogram model were largely consistent with the predicted values (χ(2) = 2.834, P = 0.944), and the C-index was 0.946 (95% CI: 0.914-0.978), demonstrating clinical validity. Monitoring these indicators is conducive to the early identification of HFRS patients with poor prognosis, providing a scientific basis for the implementation of individualized treatment and management in clinical practice. CONCLUSION: PT, FT3, WBC levels, and LAR values are risk factors for 30-day mortality in patients with HFRS. Moreover, we have, for the first time, identified a close association between FT3 and LAR and the prognosis of HFRS. The developed nomogram demonstrates favorable predictive performance and can serve as an intuitive quantitative tool for the early identification of high-risk patients, thereby guiding clinical intervention strategies.