Introduction. Leptospirosis is a re-emerging illness with a wide spectrum of clinical manifestations, from asymptomatic or moderate to severe and lethal results. Leptospirosis can be adequately treated if detected early; however, comparable clinical presentations with various other febrile illnesses or co-infections, as well as laboratory diagnosis problems can result in misdiagnosis, leading to severe illness. Identifying clinical predictors for the severe form of the disease is critical to reduce the disease complications and mortality.
The objective of the study was to establish the risk factors for mortality in patients with leptospirosis.
Materials and methods. A retrospective study of 102 medical records of patients diagnosed with leptospirosis in the period from 2009 to 2019 was conducted. Quantitative variables in the presence of normal distribution were compared using a paired Student’s t-test, and in the case of an abnormal distribution, the Mann–Whitney U test was used. The criterion χ2 was used for qualitative variables. A two-step cluster analysis was also performed.
Results. The following factors associated with death from leptospirosis have been identified: oliguria (OR, 13.5; 95% confidence interval [CI], 2.56-71.12), serum creatinine and urea levels, direct and total bilirubin, platelets, and white blood cells count.
Conclusions. These “red flag” laboratory and clinical characteristics will aid medical personnel in rapidly identifying a patient at risk of death, which is critical in determining the severity of the condition and the need for early intensive care and therapy adjustment.
Keywords: leptospirosis, mortality, predictors, risk factors.
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