Early identification of leptospirosis-associated pulmonary hemorrhage syndrome by use of a validated prediction model.

dc.creatorMarotto, Paulo Cesar Fumagalli
dc.creatorKo, Albert Icksang
dc.creatorNascimento, Cristiane Murta Ramalho
dc.creatorSeguro, Antonio Carlos
dc.creatorPrado, Rogerio R
dc.creatorBarbosa, Marcia C
dc.creatorCleto, Sergio Aparecido
dc.creatorEluf Neto, José
dc.date2015-11-25T14:44:35Z
dc.date2015-11-25T14:44:35Z
dc.date2010
dc.date.accessioned2023-09-26T23:22:18Z
dc.date.available2023-09-26T23:22:18Z
dc.identifierMAROTTO, P. C. F. et al. Early identification of leptospirosis-associated pulmonary hemorrhage syndrome by use of a validated prediction model. Journal of Infection, v. 60, n. 3, p. 218-223, 2010.
dc.identifier1532-2742
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/12318
dc.identifier10.1016/j.jinf.2009.12.005
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8889848
dc.descriptionOBJECTIVE: To identify prediction factors for the development of leptospirosis-associated pulmonary hemorrhage syndrome (LPHS). METHODS: We conducted a prospective cohort study. The study comprised of 203 patients, aged > or =14 years, admitted with complications of the severe form of leptospirosis at the Emílio Ribas Institute of Infectology (Sao Paulo, Brazil) between 1998 and 2004. Laboratory and demographic data were obtained and the severity of illness score and involvement of the lungs and others organs were determined. Logistic regression was performed to identify independent predictors of LPHS. A prospective validation cohort of 97 subjects with severe form of leptospirosis admitted at the same hospital between 2004 and 2006 was used to independently evaluate the predictive value of the model. RESULTS: The overall mortality rate was 7.9%. Multivariate logistic regression revealed that five factors were independently associated with the development of LPHS: serum potassium (mmol/L) (OR = 2.6; 95% CI = 1.1-5.9); serum creatinine (micromol/L) (OR = 1.2; 95% CI = 1.1-1.4); respiratory rate (breaths/min) (OR = 1.1; 95% CI = 1.1-1.2); presenting shock (OR = 69.9; 95% CI = 20.1-236.4), and Glasgow Coma Scale Score (GCS) < 15 (OR = 7.7; 95% CI = 1.3-23.0). We used these findings to calculate the risk of LPHS by the use of a spreadsheet. In the validation cohort, the equation classified correctly 92% of patients (Kappa statistic = 0.80). CONCLUSIONS: We developed and validated a multivariate model for predicting LPHS. This tool should prove useful in identifying LPHS patients, allowing earlier management and thereby reducing mortality.
dc.formatapplication/pdf
dc.languageeng
dc.publisherWB Saunders
dc.rightsopen access
dc.subjectHemorragia/etiologia
dc.subjectLeptospirose/complicações
dc.subjectLeptospirose/diagnóstico
dc.subjectPneumonia Bacteriana/etiologia
dc.subjectAdolescente
dc.subjectAdulto
dc.subjectBrasil
dc.subjectEstudos de Coortes
dc.subjectFeminino
dc.subjectHemorragia/mortalidade
dc.subjectHumanos
dc.subjectLeptospirose/mortalidade
dc.subjectMasculino
dc.subjectPneumonia Bacteriana/mortalidade
dc.subjectPrognóstico
dc.subjectEstudos Prospectivos
dc.subjectFatores de Risco
dc.subjectÍndice de Gravidade de Doença
dc.subjectAdulto Jovem
dc.titleEarly identification of leptospirosis-associated pulmonary hemorrhage syndrome by use of a validated prediction model.
dc.typeArticle


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