ArticleBMC infectious diseases2016
Risk factors for intensive care unit admission in patients with severe leptospirosis: a comparative study according to patients' severity.
Article in BMC infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Clinical Experience of Therapeutic Plasma Exchange (TPE) in Severe Leptospirosis: A Case Series from Sri Lanka.Tropical medicine and infectious disease · 2026Article
- The Characteristics of Patients That Develop Severe Leptospirosis: A Scoping Review.Pathogens (Basel, Switzerland) · 2025Article
- Immediate or delayed initiation of renal replacement therapy in patients with leptospirosis and acute kidney injury: a target trial emulation.Annals of intensive care · 2025Article
- Successful management of severe pulmonary form of leptospirosis with VV-ECMO, prone ventilation, and bronchoalveolar lavage: two case reports.Frontiers in medicine · 2025Article
- Factors associated with the lethality of human leptospirosis in Brazil.Cadernos de saude publica · 2025Article
- Severe leptospirosis in tropical and non-tropical areas: A comparison of two french, multicentre, retrospective cohorts.PLoS neglected tropical diseases · 2024Article
- Oliguria as a diagnostic marker of severe leptospirosis: a study from the Transcarpathian region of Ukraine.Frontiers in cellular and infection microbiology · 2024Article
- Demographic and clinical risk factors associated with severity of lab-confirmed human leptospirosis in Colombia, 2015-2020.PLoS neglected tropical diseases · 2023Article
- Development and validation of a simple machine learning tool to predict mortality in leptospirosis.Scientific reports · 2023Article
- Predictors of lethality in severe leptospirosis in Transcarpathian region of Ukraine.Le infezioni in medicina · 2022Article
- The Applicability of Commonly Used Severity of Illness Scores to Tropical Infections in Australia.The American journal of tropical medicine and hygiene · 2021Article
- Leptospirosis in Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2021Article
- An Observational Study of Human Leptospirosis in Seychelles.The American journal of tropical medicine and hygiene · 2020Observational
- Novel kidney injury biomarkers in tropical infections: a review of the literature.Revista do Instituto de Medicina Tropical de Sao Paulo · 2020Review
- Severe leptospirosis in non-tropical areas: a nationwide, multicentre, retrospective study in French ICUs.Intensive care medicine · 2019Article
- Pancreatitis as a severe complication of leptospirosis with fatal outcome: a case report.Revista do Instituto de Medicina Tropical de Sao Paulo · 2019Article
- Severe leptospirosis in Morocco: comparative data from the Amazonian area.Intensive care medicine · 2018Article
- Arrhythmias in leptospirosis-associated acute kidney injury: a case series.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
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8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study is to investigate predictive factors for intensive care unit (ICU) admission among patients with severe leptospirosis.
methodsThis is a retrospective study with all patients with severe leptospirosis admitted to a tertiary hospital. Patients were divided in ICU and ward groups. Demographical, clinical and laboratory data of the groups were compared as well as acute kidney injury (AKI) severity, according to the RIFLE criteria (R = Risk, I = Injury, F = Failure, L = Loss, E = End-stage kidney disease).
resultsA total of 206 patients were included, 83 admitted to ICU and 123 to ward. Mean age was 36 ± 15.8 years, with 85.9% males. Patients in ICU group were older (38.8 ± 15.7 vs. 34.16 ± 15.9 years, p = 0.037), had a shorter hospital stay (4.13 ± 3.1 vs. 9.5 ± 5.2 days, p = 0.0001), lower levels of hematocrit (29.6 ± 6.4 vs. 33.1 ± 8.6%, p = 0.003), hemoglobin (10.2 ± 2.4 vs. 11.6 ± 1.9 g/dL, p < 0.0001), and platelets (94,427 ± 86,743 vs. 128,896 ± 137,017/mm(3), p = 0.035), as well as higher levels of bilirubin (15.0 ± 12.2 vs. 8.6 ± 9.5 mg/dL, p = 0.001). ICU group also had a higher frequency of severe AKI (RIFLE-"Failure": 73.2% vs. 54.2%, p < 0.0001) and a higher prevalence of dialysis requirement (57.3% vs. 27.6%, p < 0.0001). Mortality was higher among ICU patients (23.5% vs. 5.7%, p < 0.0001). Independent predictors for ICU admission were tachypnea (p = 0.027, OR = 13, CI = 1.3-132), hypotension (p = 0.009, OR = 5.27, CI = 1.5-18) and AKI (p = 0.029, OR = 14, CI = 1.3-150). Ceftriaxone use was a protective factor (p = 0.001, OR = 0.13, CI = 0.04-0.4).
conclusionsIndependent risk factors for ICU admission in leptospirosis include tachypnea, hypotension and AKI. Ceftriaxone was a protective factor for ICU admission, suggesting that its use may prevent severe forms of the disease.
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