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A Scoring Tool to Predict Pulmonary Complications in Severe Leptospirosis with Kidney Failure

Rapid identification of patients likely to develop pulmonary complications in severe leptospirosis is crucial to prompt aggressive management and improve survival. The following article is a cohort study of leptospirosis patients admitted at the National Kidney and Transplant Institute (NKTI). Logis...

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Autores principales: So, Rizza Antoinette Yap, Danguilan, Romina A., Chua, Eric, Arakama, Mel-Hatra I., Ginete-Garcia, Joann Kathleen B., Chavez, Joselito R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778471/
https://www.ncbi.nlm.nih.gov/pubmed/35051123
http://dx.doi.org/10.3390/tropicalmed7010007
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author So, Rizza Antoinette Yap
Danguilan, Romina A.
Chua, Eric
Arakama, Mel-Hatra I.
Ginete-Garcia, Joann Kathleen B.
Chavez, Joselito R.
author_facet So, Rizza Antoinette Yap
Danguilan, Romina A.
Chua, Eric
Arakama, Mel-Hatra I.
Ginete-Garcia, Joann Kathleen B.
Chavez, Joselito R.
author_sort So, Rizza Antoinette Yap
collection PubMed
description Rapid identification of patients likely to develop pulmonary complications in severe leptospirosis is crucial to prompt aggressive management and improve survival. The following article is a cohort study of leptospirosis patients admitted at the National Kidney and Transplant Institute (NKTI). Logistic regression was used to predict pulmonary complications and obtain a scoring tool. The Kaplan–Meir method was used to describe survival rates. Among 380 patients with severe leptospirosis and kidney failure, the overall mortality was 14%, with pulmonary hemorrhage as the most common cause. In total, there were 85 (22.4%) individuals who developed pulmonary complications, the majority (95.3%) were observed within three days of admission. Among the patients with pulmonary complications, 56.5% died. Patients placed on mechanical ventilation had an 82.1% mortality rate. Multivariate analyses showed that dyspnea (OR = 28.76, p < 0.0001), hemoptysis (OR = 20.73, p < 0.0001), diabetes (OR = 10.21, p < 0.0001), renal replacement therapy (RRT) requirement (OR = 6.25, p < 0.0001), thrombocytopenia (OR = 3.54, p < 0.0029), and oliguria/anuria (OR = 3.15, p < 0.0108) were significantly associated with pulmonary complications. A scoring index was developed termed THe-RADS score (Thrombocytopenia, Hemoptysis, RRT, Anuria, Diabetes, Shortness of breath). The odds of developing pulmonary complications were 13.90 times higher among patients with a score >2 (63% sensitivity, 88% specificity). Pulmonary complications in severe leptospirosis with kidney failure have high mortality and warrant timely and aggressive management.
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spelling pubmed-87784712022-01-22 A Scoring Tool to Predict Pulmonary Complications in Severe Leptospirosis with Kidney Failure So, Rizza Antoinette Yap Danguilan, Romina A. Chua, Eric Arakama, Mel-Hatra I. Ginete-Garcia, Joann Kathleen B. Chavez, Joselito R. Trop Med Infect Dis Article Rapid identification of patients likely to develop pulmonary complications in severe leptospirosis is crucial to prompt aggressive management and improve survival. The following article is a cohort study of leptospirosis patients admitted at the National Kidney and Transplant Institute (NKTI). Logistic regression was used to predict pulmonary complications and obtain a scoring tool. The Kaplan–Meir method was used to describe survival rates. Among 380 patients with severe leptospirosis and kidney failure, the overall mortality was 14%, with pulmonary hemorrhage as the most common cause. In total, there were 85 (22.4%) individuals who developed pulmonary complications, the majority (95.3%) were observed within three days of admission. Among the patients with pulmonary complications, 56.5% died. Patients placed on mechanical ventilation had an 82.1% mortality rate. Multivariate analyses showed that dyspnea (OR = 28.76, p < 0.0001), hemoptysis (OR = 20.73, p < 0.0001), diabetes (OR = 10.21, p < 0.0001), renal replacement therapy (RRT) requirement (OR = 6.25, p < 0.0001), thrombocytopenia (OR = 3.54, p < 0.0029), and oliguria/anuria (OR = 3.15, p < 0.0108) were significantly associated with pulmonary complications. A scoring index was developed termed THe-RADS score (Thrombocytopenia, Hemoptysis, RRT, Anuria, Diabetes, Shortness of breath). The odds of developing pulmonary complications were 13.90 times higher among patients with a score >2 (63% sensitivity, 88% specificity). Pulmonary complications in severe leptospirosis with kidney failure have high mortality and warrant timely and aggressive management. MDPI 2022-01-11 /pmc/articles/PMC8778471/ /pubmed/35051123 http://dx.doi.org/10.3390/tropicalmed7010007 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
So, Rizza Antoinette Yap
Danguilan, Romina A.
Chua, Eric
Arakama, Mel-Hatra I.
Ginete-Garcia, Joann Kathleen B.
Chavez, Joselito R.
A Scoring Tool to Predict Pulmonary Complications in Severe Leptospirosis with Kidney Failure
title A Scoring Tool to Predict Pulmonary Complications in Severe Leptospirosis with Kidney Failure
title_full A Scoring Tool to Predict Pulmonary Complications in Severe Leptospirosis with Kidney Failure
title_fullStr A Scoring Tool to Predict Pulmonary Complications in Severe Leptospirosis with Kidney Failure
title_full_unstemmed A Scoring Tool to Predict Pulmonary Complications in Severe Leptospirosis with Kidney Failure
title_short A Scoring Tool to Predict Pulmonary Complications in Severe Leptospirosis with Kidney Failure
title_sort scoring tool to predict pulmonary complications in severe leptospirosis with kidney failure
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778471/
https://www.ncbi.nlm.nih.gov/pubmed/35051123
http://dx.doi.org/10.3390/tropicalmed7010007
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