PROGNOSTIC FACTORS OF LEPTOSPIROSIS PATIENTS IN DR. SARDJITO GENERAL HOSPITAL, YOGYAKARTA, INDONESIA

Kurniaatmaja, E.R Kurniaatmaja, E.R; Doni Priambodo; Rizka Humardewayanti; Soebagjo Loeheri

doi:10.22146/acta interna.3867

PROGNOSTIC FACTORS OF LEPTOSPIROSIS PATIENTS IN DR. SARDJITO GENERAL HOSPITAL, YOGYAKARTA, INDONESIA

https://doi.org/10.22146/acta%20interna.3867

Kurniaatmaja, E.R Kurniaatmaja, E.R^(1*), Doni Priambodo⁽²⁾, Rizka Humardewayanti⁽³⁾, Soebagjo Loeheri⁽⁴⁾

(1)
(2)
(3)
(4)
(*) Corresponding Author

Abstract

Background: Leptospirosis, an infectious disease that affects humans and animals, is a common zoonosis with a variety of clinical manifestations. Yogyakarta is one of the cities with a high incidence of leptospirosis. It is important to recognize the clinical features and prognostic factors of this disease. Severe disease can be fatal, although majority of cases are mild and self-limited.

Objective: To determine the prognostic factors for leptospirosis that associated with mortality in patients with leptospirosis in Dr. Sardjito General Hospital, Yogyakarta.

Methods: We conducted a retrospective study of data collected in our hospital between Jan 2010 until May 2011, from whom the diagnosis of leptospirosis was confirmed based on pertinent clinical and epidemiological data and positive serology.

Result: Thirty two patients were included in this study, including 29 survivors (90.62%) and 3 non-survivors (9.38%). Of these 32 patients, 26 patients (81.25%) were admitted to the medical ward and 6 patients (18.75 %) were admitted to the ICU. Multivariate logistic regression demonstrated that three factors were independently associated with mortality: oliguria (OR 0.75; CI 0.541–1.04; p<0.05); urea nitrogen > 74.7 mmol/L (OR 0.813; CI 0.642-1.028; p<0.05), and neurological symptoms (altered mentation or seizure) (OR 30; CI 4.367–206.07; p<0.05)

Conclusion: The mortality of leptospirosis remains high despite improvements in patients care. In order to improve the early treatment of high-risk patients, these 2 clinical and 1 laboratory criteria which are associated with mortality, can be used at the time of admission as prognostic factors.

Keywords : Leptospirosis, prognostic factors, mortality

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References

Vinetz JM. Leptospirosis. Curr Opin Infect Dis. 2001; 14:527–538.

Tunissea A. Anlisis Spasial Faktor Risiko Lingkungan pada Kejadian Leptospirosis di Kota Semarang. 2008; 1-4.

Murtiningsih B, Budiharta S, Supardi S. Faktor Risiko Leptospirosis di Provinsi Yogyakarta dan sekitarnya. 2005; BKM; 21:1-8.

Dupont H, Perdrizet DD, Perie JL, et al. Leptospirosis: Prognostic Factors Associated with Mortality. Clinical Infectious Diseases 1997; 25:720–4.

Unnikrishnan D, Pisharody R, Vijayalakshmy N. Prognostic Factors in Leptospirosis. A study from Kerala, India. Infectious Diseases in Clinical Practice 2005; 13:104-107.

Riwidikno H. Uji Beda. In Statistik Kesehatan : Belajar mudah teknik analisis data dalam Penelitian Kesehatan. Jogjakarta: Mitra Cendikia Press. 2007; 4-70.

Dahlan, M. Sopiyudin. Uji Hipotesis. In statistika untuk Kedokteran dan Kesehatan. Jakarta : PT. Arkans. 2006; 1-135.

Lopes AA, Costa E, Costa YA, et al. The association between serum potassium at hospital admission and the case-fatality rate of leptospirosis in men. Rev Inst Med Trop Sao Paulo. 2001; 43:217–220.

Daher E, Zanetta DM, Cavalcante MB, et al. Risk factors for death and changing patterns in leptospirosis acute renal failure. Am J Trop Med Hyg. 1999; 61:630–634

Levett PN. Leptospirosis. Clin Microbiol Rev. 2001;14:296–326

Muthusethupathi MA, Shivakumar S, Vijayakumar R, et al. Renal involvement in leptospirosis—our experience in Madras City. J Postgrad Med. 1994; 40:127–131.

Ko AI, Galvao Reis M, Ribeiro Dourado CM, et al. Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group. Lancet. 1999;354:820–825

DOI: https://doi.org/10.22146/acta%20interna.3867