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Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2022, vol. 28, issue2
Subject Area: Medicine
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DOI: 10.5272/jimab.2022282.4423
Published online: 23 June 2022
Original article
J of IMAB. 2022 Apr-Jun;28(2):4423-4430
PROGNOSTIC SCORE FOR SEVERITY OF LEPTOSPIROSIS
Galya Gancheva
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Department of Infectious Diseases, Epidemiology, Parasitology and Tropical Medicine, Faculty of Public Health, Medical University – Pleven, Bulgaria.
ABSTRACT:
The case-fatality rate of leptospirosis rises above 50% if intensive treatment is delayed. Our purpose was to create a simple score that could be used quickly to identify patients at the greatest risk.
Material and Methods: One hundred consecutive patients with leptospirosis treated in the Clinic of Infectious Diseases at University Hospital “Dr Georgi Stranski” - Pleven (1976-2018) were distributed retrospectively in groups with a non-severe and severe course (66 and 34, respectively). The once interesting prognosis was an eventual risk for the severe course. Data were analyzed using statistical software (IВМ SPSS Statistics 19.0).
Results: The multivariate analysis identified seven variables independent associated with severe course: age ≥60 years OR (95% CI):15.45 (12.21–19.7), hospital admission >4 days after the clinical onset OR (95% CI):4.18 (2.23–7.86; oligo/anuria OR (95% CI):10.95 (3.2–19.8); hypotension OR (95% CI):13.936 (6.5–19.9); pulmonary findings OR (95% CI):25.45 (17.5–32.4); arrhythmia OR (95% CI):15.5 (10.2–19.6), and hemorrhages OR (95% CI):21.6 (18.3– 29.7). The mentioned variables (awarded one point each) were used to generate a seven-point prognostic score. The risk for severe course increased incrementally. A score of two, three, four or five had a positive predictive value of 30%, 38%, 74% and 89%, respectively (95% CI:28–39, 32–43, 60 – 90, 70–92, respectively). A score of six or seven had a positive predictive value of 100% (95% CI: 96–100 and 98–100, respectively).
Conclusion: A simple seven-point clinical based prognostic score would help clinicians identify people at risk of severe leptospirosis and initiate prompt intensive treatment, including hemodialysis.
Keywords: leptospirosis, prognosis, score,
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Please cite this article as: Gancheva G. Prognostic score for severity of leptospirosis. J of IMAB. 2022 Jan-Mar;28(1):4423-4430. DOI: 10.5272/jimab.2022282.4423
Correspondence to: Galya Ivanova Gancheva, Clinic of Infectious Diseases, University Hospital, Medical University Pleven; 8A “Georgi Kochev” Str., Pleven 5800, Bulgaria; E-mail: galya_gancheva@abv.bg
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Received: 18 December 2021
Published online: 23 June 2022