Acute lung injury in leptospirosis: clinical and laboratory features, outcome, and factors associated with mortality.
Forty-two consecutive patients with leptospirosis and acute lung injury who were mechanically ventilated were analyzed in a prospective cohort study. Nineteen patients (45%) survived, and 23 (55%) died. Multivariate analysis revealed that 3 variables were independently associated with mortality: hemodynamic disturbance (odds ratio [OR], 6.0; 95% confidence interval [CI], 0.9-38.8; P=. 047), serum creatinine level >265.2 micromol/L (OR, 10.6; 95% CI, 0. 9-123.7; P =.026), and serum potassium level >4.0 mmol/L (OR, 19.9; 95% CI, 1.2-342.8; P=.009). These observations can be used to identify factors associated with mortality early in the course of severe respiratory failure in leptospirosis.
Marotto
P C
PC
Intensive Care Unit, Instituto de Infectologia Emilio Ribas, Universidade de São Paulo, São Paulo, Brazil.
Nascimento
C M
CM
Eluf-Neto
J
J
Marotto
M S
MS
Andrade
L
L
Sztajnbok
J
J
Seguro
A C
AC
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000209:etiology / Q000401:mortality / Q000628:therapy; D006801:Humans; D007919:Leptospira / Q000302:isolation & purification; D007922:Leptospirosis / Q000150:complications* / Q000382:microbiology; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000097:blood / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011188:Potassium / Q000097:blood; D011446:Prospective Studies; D012121:Respiration, Artificial; D016019:Survival Analysis; D015996:Survival Rate
D003404:Creatinine; D011188:Potassium