Acute Lung Injury in Leptospirosis: Clinical and Laboratory Features, Outcome, and Factors Associated with Mortality

• Published in: Clinical infectious diseases 1999-12, Vol.29 (6), p.1561-1563
• Main Authors: Marotto, Paulo C. F., Nascimento, Cristiane M. R., Eluf-Neto, Jose, Marotto, Marcia S., Andrade, Lucia, Sztajnbok, Jaques, Seguro, Antonio C.
• Format: Article
• Language: English
• Subjects: Acute Disease; Acute lung injury; Adolescent; Adult; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Bleeding; Cohort Studies; Creatinine - blood; Death; Female; Follow-Up Studies; Hemodynamics; Hemorrhage; Hemorrhage - etiology; Hemorrhage - mortality; Hemorrhage - therapy; Human bacterial diseases; Humans; Infectious diseases; Intensive care units; Leptospira; Leptospira - isolation & purification; Leptospirosis; Leptospirosis - complications; Leptospirosis - microbiology; Lung - pathology; Lung Diseases - blood; Lung Diseases - etiology; Lung Diseases - therapy; Male; Medical sciences; Middle Aged; Mortality; Multivariate Analysis; Potassium; Potassium - blood; Prospective Studies; Respiration, Artificial; Respiratory insufficiency; Survival Analysis; Survival Rate; Tropical medicine
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/313501

Forty-two consecutive patients with leptospirosis and acute lung injury who were mechanically ventilated were analyzed in a prospective cohort study. Nineteen patients (45%) survived, and 23 (55%) died. Multivariate analysis revealed that 3 variables were independently associated with mortality: hemodynamic disturbance (odds ratio [OR], 6.0; 95% confidence interval [CI], 0.9–38.8; P=.047), serum creatinine level >265.2 µmol/L (OR, 10.6; 95% CI, 0.9–123.7; P =.026), and serum potassium level >4.0 mmol/L (OR, 19.9; 95% CI, 1.2–342.8; P=.009). These observations can be used to identify factors associated with mortality early in the course of severe respiratory failure in leptospirosis.