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Predictors of Mortality in Scrub Typhus Infection Requiring Intensive Care Admission in Tertiary Healthcare Centre of Nepal

INTRODUCTION: This study aimed to explore the predictors of mortality from scrub typhus infection in patients requiring intensive care unit (ICU) admission. MATERIALS AND METHODS: A retrospective study was conducted on 120 patients with serum ELISA IgM positive for scrub typhus (optical density ≥ 0....

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Autores principales: Adhikari, Shital, Poudel, Ramesh Sharma, Shrestha, Shakti, Lamichhane, Praves
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008690/
https://www.ncbi.nlm.nih.gov/pubmed/29971099
http://dx.doi.org/10.1155/2018/4867958
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author Adhikari, Shital
Poudel, Ramesh Sharma
Shrestha, Shakti
Lamichhane, Praves
author_facet Adhikari, Shital
Poudel, Ramesh Sharma
Shrestha, Shakti
Lamichhane, Praves
author_sort Adhikari, Shital
collection PubMed
description INTRODUCTION: This study aimed to explore the predictors of mortality from scrub typhus infection in patients requiring intensive care unit (ICU) admission. MATERIALS AND METHODS: A retrospective study was conducted on 120 patients with serum ELISA IgM positive for scrub typhus (optical density ≥ 0.5) admitted at the medical ICU of Chitwan Medical College Teaching Hospital between April 2016 and September 2017. Data was extracted from patient medical records and electronic database of the hospital. The outcome measurement was mortality (Yes/No) due to the infection. A multivariate binary logistic regression analysis (p < 0.10) using potential variables from bivariate analysis (p < 0.25) was adjusted to predict the mortality. RESULTS: The mortality rate was 20% (24/120). Factors associated with mortality, as found using bivariate analysis, were heart rate > 100/minute (p < 0.001), systolic blood pressure < 90 mmHg (p = 0.025), diastolic blood pressure < 60 mmHg (p = 0.032), serum creatinine > 1.4 mg/dl (p < 0.001), acute kidney injury requiring dialysis (p = 0.029), acute respiratory distress syndrome (p < 0.001), and shock requiring vasopressor (p < 0.001). Regression analysis showed age (odds ratio [OR] = 1.063; 95% CI = 1.010–1.118; p = 0.019) and serum creatinine (OR = 1.063; 95% CI = 1.010–1.118; p = 0.019) as significant predictors of poor outcome. CONCLUSION: Older age and high serum creatinine were found to be independent predictors of poor outcome in patients with scrub typhus admitted in medical ICU.
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spelling pubmed-60086902018-07-03 Predictors of Mortality in Scrub Typhus Infection Requiring Intensive Care Admission in Tertiary Healthcare Centre of Nepal Adhikari, Shital Poudel, Ramesh Sharma Shrestha, Shakti Lamichhane, Praves Interdiscip Perspect Infect Dis Research Article INTRODUCTION: This study aimed to explore the predictors of mortality from scrub typhus infection in patients requiring intensive care unit (ICU) admission. MATERIALS AND METHODS: A retrospective study was conducted on 120 patients with serum ELISA IgM positive for scrub typhus (optical density ≥ 0.5) admitted at the medical ICU of Chitwan Medical College Teaching Hospital between April 2016 and September 2017. Data was extracted from patient medical records and electronic database of the hospital. The outcome measurement was mortality (Yes/No) due to the infection. A multivariate binary logistic regression analysis (p < 0.10) using potential variables from bivariate analysis (p < 0.25) was adjusted to predict the mortality. RESULTS: The mortality rate was 20% (24/120). Factors associated with mortality, as found using bivariate analysis, were heart rate > 100/minute (p < 0.001), systolic blood pressure < 90 mmHg (p = 0.025), diastolic blood pressure < 60 mmHg (p = 0.032), serum creatinine > 1.4 mg/dl (p < 0.001), acute kidney injury requiring dialysis (p = 0.029), acute respiratory distress syndrome (p < 0.001), and shock requiring vasopressor (p < 0.001). Regression analysis showed age (odds ratio [OR] = 1.063; 95% CI = 1.010–1.118; p = 0.019) and serum creatinine (OR = 1.063; 95% CI = 1.010–1.118; p = 0.019) as significant predictors of poor outcome. CONCLUSION: Older age and high serum creatinine were found to be independent predictors of poor outcome in patients with scrub typhus admitted in medical ICU. Hindawi 2018-06-03 /pmc/articles/PMC6008690/ /pubmed/29971099 http://dx.doi.org/10.1155/2018/4867958 Text en Copyright © 2018 Shital Adhikari et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Adhikari, Shital
Poudel, Ramesh Sharma
Shrestha, Shakti
Lamichhane, Praves
Predictors of Mortality in Scrub Typhus Infection Requiring Intensive Care Admission in Tertiary Healthcare Centre of Nepal
title Predictors of Mortality in Scrub Typhus Infection Requiring Intensive Care Admission in Tertiary Healthcare Centre of Nepal
title_full Predictors of Mortality in Scrub Typhus Infection Requiring Intensive Care Admission in Tertiary Healthcare Centre of Nepal
title_fullStr Predictors of Mortality in Scrub Typhus Infection Requiring Intensive Care Admission in Tertiary Healthcare Centre of Nepal
title_full_unstemmed Predictors of Mortality in Scrub Typhus Infection Requiring Intensive Care Admission in Tertiary Healthcare Centre of Nepal
title_short Predictors of Mortality in Scrub Typhus Infection Requiring Intensive Care Admission in Tertiary Healthcare Centre of Nepal
title_sort predictors of mortality in scrub typhus infection requiring intensive care admission in tertiary healthcare centre of nepal
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008690/
https://www.ncbi.nlm.nih.gov/pubmed/29971099
http://dx.doi.org/10.1155/2018/4867958
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