Leptospirosis: Prognostic factors associated with mortality
Leptospirosis: Prognostic factors associated with mortality
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DOI：
10.1086/513767
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发表时间：
1997-09-01
影响因子：
11.8
通讯作者：
Daijardin, JB
中科院分区：
文献类型：
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作者：
Dupont, H;DupontPerdrizet, D;Daijardin, JB
为了确定钩端螺旋体病的预后因素，我们对1989年至1993年期间在我院急诊科收集的数据进行了回顾性研究。本研究纳入了68名根据相关临床和流行病学数据以及阳性血清学诊断为钩端螺旋体病的患者。 56 名患者（82%）出院，12 名患者（18%）死亡。多变量逻辑回归表明，五个因素与死亡率独立相关：呼吸困难（比值比 [OR]，11.7；95% 置信区间 [CI]，2.8-48.5；P < .05）、少尿（OR，9；CI，2.1-37.9；P < .05）；白细胞计数 >12,900/mm(3)（OR，2.5；CI，1,8-3.5；P < .01），心电图复极异常（OR，5,9；CI，1.4-24.8；P 小于或等于 0.01），胸片上肺泡浸润（OR，7.3；CI， 1.7-31.7；P小于或等于0.01)。入院时识别这些因素可能为需要早期转移到重症监护病房的患者提供有用的选择标准。
To determine the prognostic factors for leptospirosis, we conducted a retrospective study of data collected in the emergency department of our hospital between 1989 and 1993. Sixty-eight patients, for whom the diagnosis of leptospirosis was based on pertinent clinical and epidemiological data and positive serology, were included in this study. Fifty-six patients (82%) were discharged from the hospital, and 12 (18%) died. Multivariate logistic regression demonstrated that five factors were independently associated with mortality: dyspnea (odds ratio [OR], 11.7; 95% confidence interval [CI], 2.8-48.5; P < .05), oliguria (OR, 9; CI, 2.1-37.9; P < .05); white blood cell count, >12,900/mm(3) (OR, 2.5; CI, 1,8-3.5; P < .01), repolarization abnormalities on elcctrocardiograms (OR, 5,9; CI, 1.4-24.8; P less than or equal to .01), and alveolar infiltrates on chest radiographs (OR, 7.3; CI, 1.7-31.7; P less than or equal to .01). Identification of these factors on admission might provide useful selection criteria for patients who need early transfer to the intensive care unit.