Prognostic Factors of Non-survivor Leptospirosis Si Sa Ket Hospital

Abstract

Background: Leptospirosis is one of the most important zoo notic diseases with high incidence rates, especially in tropical countries. Si Sa Ket, one of Thailand's northeastern provinces, has been recognized with being in the top highest morbidity rates and had the highest number of death cases in 2017.
Objectives: To interpret the case fatality rates, characteristics, clinical signs and symptoms, the laboratory finding and determine the prognostic factors predicting the likelihood of death in patients diagnosed with Leptospirosis at Si Sa Ket Hospital
Methods: A prognostic retrospective cohort study practiced in diagnosed of leptospirosis on medical records in 2017. The calculated sample size was at least 161 people, analyzed with descriptive statistics and survival analysis.
Results: The total number of leptospirosis cases was 399. There were 47 death cases (CFR of 11.8%). The prognostic factors since the first admission comprised 4 factors which were (1) over 45 years old. (aHR = 2.3),(2) respiratory rate greater than 27 times / minute (aHR = 4.2), (3) albumin levels lower than 2.5 g / dL (aHR = 2.1) and (4) AST / ALT ratio ≥ 2 (aHR = 2.0,). The progression of the disease considered as raising the possibility of death were oliguria (HR = 6.0), shock (HR = 43.2,), thrombocytopenia (HR = 7.0), pulmonary hemorrhage (HR = 5.0) and respiratory failure (HR = 112.1).
Conclusion: Recognizing the prognostic factors predicting the likelihood of death since the first admission and the progression of the disease during hospitalization would be beneficial for adopting more efficient surveillance to enhance the monitoring of patients and be able to early management for reduce the mortality rate of the disease.
Keywords: Leptospirosis, Prognostic factors, Death, Disease progression