David Vandroux1, Paul Chanareille2, Benjamin Delmas2, Bernard-Alex Gaüzère3, Nicolas Allou2, Loic Raffray4, Marie-Christine Jaffar-Bandjee5, Olivier Martinet2, Cyril Ferdynus6, Julien Jabot2. 1. Intensive Care Unit, Félix Guyon Hospital, University Teaching Hospital of La Réunion, CS11021, 97400 Saint Denis, Reunion Island, France; René Labusquière Centre of Tropical Medicine, University of Bordeaux, 33076 Bordeaux Cedex, France; INSERM, CIC 1410, F-97410 Saint-Pierre, France. Electronic address: vandroux.david@gmail.com. 2. Intensive Care Unit, Félix Guyon Hospital, University Teaching Hospital of La Réunion, CS11021, 97400 Saint Denis, Reunion Island, France. 3. Intensive Care Unit, Félix Guyon Hospital, University Teaching Hospital of La Réunion, CS11021, 97400 Saint Denis, Reunion Island, France; René Labusquière Centre of Tropical Medicine, University of Bordeaux, 33076 Bordeaux Cedex, France. 4. Department of Internal Medicine, Félix-Guyon University Hospital of La Réunion, Saint Denis, Réunion Island, France. 5. Microbiology/Virology Laboratory, CHU La Réunion site Félix Guyon, St Denis, La Réunion, France. 6. Unité de soutien méthodologique, CHU La Réunion, F-97400 Saint Denis, France.
Abstract
PURPOSE: Acute Respiratory Distress Syndrome is a major complication of leptospirosis, leading to the majority of fatalities. METHODS: Retrospective, descriptive and single-center cohort study. The primary outcome was the Standardized Mortality Ratio (SMR) for ARDS in leptospirosis based on the quartiles of the SAPS2 score in the reference population of 1683 patients hospitalized for ARDS. The second outcomes were to determine the risk factors of mortality of ARDS in leptospirosis and to describe the cases requiring Extracorporeal Membrane Oxygenation (ECMO). RESULTS: Of 172 leptospirosis patients from January 2004 to October 2017, 39 (23%) presented a moderate or severe ARDS with a mortality rate of 23% (9 cases). Among patients with ARDS, the SMR with regards to Simplified Acute Physiology Score II was 0.49 (CI95%: 0.21; 0.96). Risk factors associated with mortality found by bivariate analysis were Severity Acute Physiology Score II (p = 0.01), Sequential Organ Failure Assessment (p = 0.01), base excess (p = 0.002), kaliemia (p = 0.004), bilirubinemia (p = 0.01) and level of aspartate aminotransferase (p = 0.01). Eight patients underwent ECMO for refractory ARDS and six survived. CONCLUSIONS: Leptospirosis can induce serious but transient ARDS with a better prognosis than that of other causes of ARDS. Several patients have been successfully treated with ECMO.
PURPOSE:Acute Respiratory Distress Syndrome is a major complication of leptospirosis, leading to the majority of fatalities. METHODS: Retrospective, descriptive and single-center cohort study. The primary outcome was the Standardized Mortality Ratio (SMR) for ARDS in leptospirosis based on the quartiles of the SAPS2 score in the reference population of 1683 patients hospitalized for ARDS. The second outcomes were to determine the risk factors of mortality of ARDS in leptospirosis and to describe the cases requiring Extracorporeal Membrane Oxygenation (ECMO). RESULTS: Of 172 leptospirosispatients from January 2004 to October 2017, 39 (23%) presented a moderate or severe ARDS with a mortality rate of 23% (9 cases). Among patients with ARDS, the SMR with regards to Simplified Acute Physiology Score II was 0.49 (CI95%: 0.21; 0.96). Risk factors associated with mortality found by bivariate analysis were Severity Acute Physiology Score II (p = 0.01), Sequential Organ Failure Assessment (p = 0.01), base excess (p = 0.002), kaliemia (p = 0.004), bilirubinemia (p = 0.01) and level of aspartate aminotransferase (p = 0.01). Eight patients underwent ECMO for refractory ARDS and six survived. CONCLUSIONS:Leptospirosis can induce serious but transient ARDS with a better prognosis than that of other causes of ARDS. Several patients have been successfully treated with ECMO.
Authors: Kris Salaveria; Simon Smith; Yu-Hsuan Liu; Richard Bagshaw; Markus Ott; Alexandra Stewart; Matthew Law; Angus Carter; Josh Hanson Journal: Am J Trop Med Hyg Date: 2021-10-18 Impact factor: 3.707
Authors: Carolina Rodrigues Felix; Jill C Roberts; Priscilla L Winder; Rashmi Gupta; M Cristina Diaz; Shirley A Pomponi; Amy E Wright; Kyle H Rohde Journal: Mar Drugs Date: 2019-12-16 Impact factor: 5.118
Authors: Rizza Antoinette Yap So; Romina A Danguilan; Eric Chua; Mel-Hatra I Arakama; Joann Kathleen B Ginete-Garcia; Joselito R Chavez Journal: Trop Med Infect Dis Date: 2022-01-11