title: Different patterns in a cohort of patients with severe leptospirosis (Weil syndrome): effects of an educational program in an endemic area.
abstract: The aim of this study is to investigate the changes in clinical pattern and therapeutic measures in leptospirosis-associated acute kidney injury; a retrospective study with 318 patients in Brazil. Patients were divided according to the time of admission: 1985-1996 (group I) and 1997-2010 (group II). Patients were younger in group I (36 ± 13 versus 41 ± 16 years, P = 0.005) and the numbers of oliguria increased (21% versus 41% in group II, P = 0.014). Higher frequency of lung manifestations was observed in group II (P < 0.0001). Although increased severity, there was a significant reduction in mortality (20% in group I versus 12% in group II, P = 0.03). Mortality was associated with advanced age, low diastolic blood pressure, oliguria, arrhythmia, and peritoneal dialysis, besides a trend to better mortality with penicillin administration. Leptospirosis is occurring in an older population, with a higher number of oliguria and lung manifestations. However, mortality is decreasing and can be the result of changes in treatment.
authors: Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors: Elizabeth F
authors: EF
authors: Daher
authors: Geraldo B
authors: GB
authors: Silva
authors: Rafael S A
authors: RS
authors: Lima
authors: Rosa M S
authors: RM
authors: Mota
authors: Hermano A L
authors: HA
authors: Rocha
authors: Krasnalhia Lívia S
authors: KL
authors: de Abreu
authors: Adller G C
authors: AG
authors: Barreto
authors: Eanes D B
authors: ED
authors: Pereira
authors: Sônia M H A
authors: SM
authors: Araújo
authors: Alexandre B
authors: AB
authors: Libório
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D019353:Endemic Diseases / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D012189:Retrospective Studies; D014895:Weil Disease / Q000097:blood / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control*; D055815:Young Adult