Severe cases of leptospirosis may be fatal. Identification of risk factors for a fatal outcome may help identify patients who would benefit from early and aggressive interventions.
Risk factors identified by Daher et al:
(1) oliguria (only independent factor for death by logistic regression)
Risk factors identified by Dupont et al:
(1) dyspnea
(2) alveolar infiltrates on chest X-rays
(3) oliguria
(4) repolarization abnormalities in the ECG
(5) leukocyte count > 12,900 per µL
Risk factors identified by Ko et al using multivariate analysis:
(1) altered mental status (strongest independent predictor of death), with confusion , obtundation, stupor or coma
(2) increasing age (age > 37 years)
(3) renal insufficiency (oliguria, serum creatinine > 354 µmol/L, BUN > 54 mmol/L)
(4) respiratory insufficiency
The presence of altered mental status, renal failure plus increasing age had an 82% positive predictive value for death.
Risk factors identified by Marotto et al in patients with acute lung injury:
(1) shock (defined as need for vasoactive drugs to maintain systolic blood pressure >= 80 mm Hg after fluid replacement therapy)
(2) serum creatinine level > 265.2 µmol/L (> 3.0 mg/dL)
(3) serum potassium > 4.0 mmol/L
Other factors reported to be associated with poor prognosis, but not confirmed during data analysis:
(1) increasing age
(2) jaundice with elevated total serum bilirubin
(3) female gender
Purpose: To identify patients with leptospirosis with risk factors associated with poor survival.
Specialty: Infectious Diseases
Objective: risk factors, prevention
ICD-10: A27,