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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Predictors of lethality in severe leptospirosis in urban Brazil.
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Predictors of lethality in severe leptospirosis in urban Brazil.

机译：巴西城市严重钩端螺旋体病致死率的预测指标。

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摘要

To ascertain prognostic factors associated with fatal outcomes in severe leptospirosis, a retrospective case-control study was done using population-based surveillance data. Centralized death certificate reporting of leptospirosis mortality was combined with details of patients' hospitalizations, which were obtained from hospitals representing all sectors of Sao Paulo city. Among identified leptospirosis cases, 89 lethal cases and 281 survivor cases were analyzed. Predictors of death included age>40 years, development of oliguria, platelet count<70,000/microL, creatinine>3 mg/dL, and pulmonary involvement. The latter was the strongest risk factor with an estimated odds ratio of 6.0 (95% confidence interval: 3.0-12.0). Serologic findings with highest titer against Leptospira interrogans serovar Copenhageni did not show significant differences between survivors and non-survivors. Lung involvement was an important predictor of death in leptospirosis in Sao Paulo, of relevance in leptospirosis-endemic regions where this complication is common.
机译：为了确定与严重钩端螺旋体病致命结果相关的预后因素，使用基于人群的监测数据进行了回顾性病例对照研究。报告了钩端螺旋体病死亡率的集中死亡证明书以及患者住院的详细信息，这些详细信息是从代表圣保罗各部门的医院获得的。在确定的钩端螺旋体病病例中，分析了89例致命病例和281例幸存者病例。死亡的预测因素包括年龄> 40岁，少尿发展，血小板计数<70,000 / microL，肌酐> 3 mg / dL和肺部受累。后者是最强的危险因素，估计的优势比为6.0（95％置信区间：3.0-12.0）。抗问号钩端螺旋体血清哥本哈根杆菌滴度最高的血清学检查结果未显示幸存者和非幸存者之间存在显着差异。肺部受累是圣保罗钩端螺旋体病死亡的重要预测指标，与这种并发症常见的钩端螺旋体病流行地区有关。

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