Prognostic factors for Leptospirosis Infection Severity

• Published in: Tropical medicine and infectious disease Vol. 8; no. 2; pp. 1 - 12
• Main Authors: Pongpan, Surangrat, Thanatrakolsri, Pantitcha, Vittaporn, Supa, Khamnuan, Patcharin, Daraswang, Punnaphat
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland MDPI 01.02.2023; MDPI AG
• Subjects: Acute renal failure; Anuria; Blood cell count; Blood pressure; Care and treatment; Clinical medicine; Creatinine; Data collection; Dengue fever; Epidemiology; Evaluation; Fatalities; Headaches; Hematology; Hemodynamics; Hemoptysis; Hospitals; Illnesses; Infections; Laboratories; Leptospirosis; Medical prognosis; Medical records; Medical research; Medicine, Experimental; Meningitis; Oliguria; Prognosis; prognostic factors; respiratory failure; Respiratory insufficiency; severe leptospirosis; Tropical diseases; Urine; Thailand; respiratory failure; prognostic factors; acute renal failure; severe leptospirosis
• ISSN: 2414-6366; 2414-6366
• DOI: 10.3390/tropicalmed8020112

Background: Leptospirosis is an important health problem in Thailand. People infected with leptospirosis may not have any mild symptoms, whereas some people have acute and severe illnesses. It is crucial to strengthen critical patients' diagnosis and treatment to prevent severe complications and reduce mortality. This study was performed to explore a set of parameters for the prediction of severe leptospirosis illness under routine clinical practice. Methods: A case-control study was conducted in eight general hospitals in Thailand. Retrospective collection data were used, and key information was retrieved from inpatient medical files. Patients were grouped into two severity categories, severe and non-severe infection. Backward elimination was used to reach the final multivariate model. Results: The six significant predictors identified in the study were hemoptysis (OR = 25.80, 95% CI 5.69, 116.92), hypotension (blood pressure < 90/60 mmHg) (OR = 17.33, 95% CI 6.89, 43.58), platelet count < 100,000/ L (OR = 8.37, 95% CI 4.65, 15.09), white blood cell count (WBC) > 14,000/ L (OR = 5.12, 95% CI 2.75, 9.51), hematocrit 30% (OR = 3.49, 95% CI 1.61, 7.57), and jaundice (OR = 3.11, 95% CI 1.71, 5.65). These predictors could correctly predict the severity of leptospirosis infection in 91.31% of the area under the receiver operation curve (AuROC). Conclusions: The results of this study showed that severe leptospirosis infections have identifiable predictors. The predictors may be used to develop a scoring system for predicting the level of severity.