Risk factors for neurological complications in complete hemolytic uremic syndrome caused by Escherichia coli O157.
BACKGROUND
The aim of the present study was to investigate the predictive parameters for encephalopathy in complete hemolytic uremic syndrome (HUS) in a large outbreak of O157: H7 infection in 1996.


METHODS
A total of 182 inpatients, 71 of whom had complete HUS, including 12 patients with neurological complications, and 46 colitis patients were studied. Presenting signs and symptoms (n = 115) and laboratory data (n = 69) were analyzed using monovariate and multivariate analysis.


RESULTS
After adjusting for age and gender, logistic regression showed that presenting symptoms such as bloody diarrhea (odds ratio [OR] = 7.39), proteinuria (OR = 6.16), hematuria (OR = 8.31), oliguria (OR = 17.4) and a pale face (OR = 10.7) were useful for predicting complete HUS. Also, increased white blood cell counts >12,000 microL/mL (OR = 10.0) and C-reactive protein >1.5 mg/dL (OR = 7.39) at the onset of infection, were useful as predictive laboratory parameters. To predict neurological complications in complete HUS patients, the average daily increase of lactate dehydrase >1200 IU/L per day (OR = 26.3) and creatinine >0.5 mg/dL per day (OR = 12) were found to be useful on multivariate logistic regression.


CONCLUSIONS
There are useful predictive clinical factors for neurological complications in complete HUS.
Yamamoto
Takehisa
T
Department of Pediatrics, Minoh City Hospital, Osaka, Japan. takehisa_yamamoto@maple.city.minoh.lg.jp
Satomura
Kenichi
K
Okada
Shintaro
S
Ozono
Keiichi
K
D001927:Brain Diseases / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D003404:Creatinine / Q000097:blood; D019453:Escherichia coli O157; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012307:Risk Factors
D003404:Creatinine; D007770:L-Lactate Dehydrogenase