LEPTOSPIROSIS - PROGNOSTIC FACTORS ASSOCIATED WITH MORTALITY

To determine the prognostic factors for leptospirosis, we conducted a retrospective study of data collected in the emergency department of o ur hospital between 1989 and 1993. Sixty-eight patients, for whom the diagnosis of leptospirosis was based on pertinent clinical and epidemi ological data and positive serology, were included in this study. Fift y-six patients (82%) were discharged from the hospital, and 12 (18%) d ied. Multivariate logistic regression demonstrated that five factors w ere independently associated with mortality: dyspnea (odds ratio [OR], 11.7; 95% confidence interval [CI], 2.8-48.5; P < .05), oliguria (OR, 9; CI, 2.1-37.9; P < .05); white blood cell count, >12,900/mm(3) (OR, 2.5; CI, 1,8-3.5; P < .01), repolarization abnormalities on elcctroca rdiograms (OR, 5,9; CI, 1.4-24.8; P less than or equal to .01), and al veolar infiltrates on chest radiographs (OR, 7.3; CI, 1.7-31.7; P less than or equal to .01). Identification of these factors on admission m ight provide useful selection criteria for patients who need early tra nsfer to the intensive care unit.