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Leptospirosis: prognostic factors associated with mortality
H Dupont1, D Dupont-Perdrizet, J L Perie
1Medical, Surgical, and Burn Intensive Care Unit, Pointe-à-Pître Hospital, Antilles-Guyane University, French West Indies.
Summary
Five factors, including dyspnea and oliguria, predict mortality in leptospirosis patients. Early identification aids intensive care unit (ICU) transfer decisions for severe leptospirosis cases.
Area of Science:
- Infectious Diseases
- Clinical Medicine
- Epidemiology
Background:
- Leptospirosis is a zoonotic disease with variable clinical presentations.
- Identifying prognostic factors is crucial for managing severe cases and improving patient outcomes.
Purpose of the Study:
- To identify independent prognostic factors associated with mortality in hospitalized leptospirosis patients.
- To establish criteria for early identification of high-risk patients requiring intensive care.
Main Methods:
- Retrospective study of 68 leptospirosis patients diagnosed between 1989 and 1993.
- Data collected from emergency department admissions.
- Multivariate logistic regression analysis to determine independent predictors of mortality.
Main Results:
- Mortality rate was 18% (12 out of 68 patients).
- Independent predictors of mortality included dyspnea, oliguria, elevated white blood cell count (>12,900/mm3), electrocardiogram repolarization abnormalities, and alveolar infiltrates on chest radiographs.
- Odds ratios ranged from 2.5 to 11.7 for these factors.
Conclusions:
- Dyspnea, oliguria, high WBC count, ECG abnormalities, and chest X-ray infiltrates are significant prognostic factors for leptospirosis mortality.
- These factors can aid in selecting patients for early intensive care unit transfer.
- Early risk stratification can potentially improve outcomes for severe leptospirosis.