Risk factors - in patients of Leptospirosis with ARF
Abstract
100 patients of leptospirosis admitted at New Civil Hospital Surat, having ELISA IgM > 20 positive, with serum creatinine > 1.5 mg% have been included in the present study. Detailed clinical history and physical examination was done of admitted patients in medical ward. Laboratory investigations carried out included Hb, TC, DC, PSMP, serum protein, RBS, platelet count, ECG, X-ray chest, serum electrolytes, prothrombin time, SGPT, serum creatinine, serum bilirubin, HIV, HCV and HBsAg. USG Abdomen was done in all patients. Patients with anuria (u/o < = 100 ml) had very high mortality of 42%. Patients with oliguria (u/o 101-500 ml) had 19% mortality and nonoliguric patients (u/o > 500 ml) had only 4% mortality (p value = 0.0004). Thus mortality increases with decrease
in urine output. Patients with oliguria and hypotension had 44% mortality as compared to no mortality in patients with non-oliguria and hypotension. Thus oliguria and hypotension both together increase the mortality (p value < 0.01). Involvement of respiratory system in oliguric patients increases mortality to 52% (p value < 0.05). Oliguria (p = 0.001), respiratory system involvement (p = 0.0001), and altered consciousness (p < 0.01) were significantly associated with mortality irrespective of oliguric or non-oliguric renal failure and they can be considered as increased risk factors for mortality in patients of Leptospirosis with ARF.
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