Prognostic Factors Associated with Severe Leptospirosis
SOMPONG TANTITANAWAT, MD*,
SANSANEE T ANJATHAM, MSc**
Affiliation : * Department of Medicine, Phrae Hospital, Phrae 54000,
** Regional Medical Sciences Center, Department of Medical Sciences, Phitsanulok 65000, Thailand.
AbstractTo determine the prognostic factors associated with severity and death of leptospirosis. the
authors conducted a hospital based cross sectional study by collecting data of adult patients that were
admitted to Phrae Hospital for leptospirosis from 1998 to 2001. The serology was confirmed with a
microscopic agglutination test (MAT). The variables obtained from the history, examination, behavioral
risks, investigations, and initial treatment especially the data of the first day of admission were examined
for association with severity. Of 362 patients, 214 were classed as nonsevere patients, 81 were severe
with complications (serum creatinine~ 3 mg/dl and/or patients with respiratory failure) and 67 died.
Multivariate logistic regression demonstrated that five factors were independently associated with
severity : hemoptysis, platelet count (Pit) < 100,000/mm total bilirubin > 2.5 mg/dl, white blood cell
count> 13,000/mm3 and hematocrit (Hct) < 30 per cent. Five factors associated with mortality are : res
piratory failure (or respiratory rate; RR > 24/min), hemoptysis, oliguria, metabolic acidosis (or bicarbo
nate < 20mmol/l) and thrombocytopenia (or Pit< 100,000/mm3 Identification of these factors might
).
provide useful selection criteria for patients who need early admission or transfer to the intensive care
unit
Keywords : Severe Leptospirosis, Mortality, Acute Renal Failure, Respiratory Failure
All Articles
Download
