title: Risk factors for neurological complications in complete hemolytic uremic syndrome caused by Escherichia coli O157.
abstract: 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.
authors.affiliation: Department of Pediatrics, Minoh City Hospital, Osaka, Japan. takehisa_yamamoto@maple.city.minoh.lg.jp
authors.forename: Takehisa
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Satomura
authors.forename: Shintaro
authors.initials: S
authors.lastname: Okada
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ozono
mesh_terms: 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
chemical_list: D003404:Creatinine; D007770:L-Lactate Dehydrogenase