34 Independent Risk Factors for Death Risks Cox-regression ModelHaz. Ratio 95%CI p*Hypotension(Need Dopamine)Oliguria (<400 cc/d)HyperkalemiaPulmonary rales* p-value from partial likely hood ratio test
35 Conclusions 1. Mortality rate 1.4 per 100 patient-days (95%CI: )2. Overall survival timeat 1 week was 91.4%at 2 week was 82.7%3. Hypotension, oliguria, hyperkalemia andpulmonary rales were the significantindependent risk factors for death inleptospirosis.
37 Suggestions 1. Urine volume record (ml.) 2. Clinical close monitoring in 1st week3. District hospital : referral indication3.1 urine < 200 ml./12 hr. or3.2 pulmonary rales. or3.3 hypotension4. Tertiary center4.1 Early dialysisurine <200 ml/12hr or K > 5 mmol/l4.2 Early intubation: tachypnea and rales4.2 ICU care for pulmonary complication4.3 Intermediate care of leptospirosis
38 Serovars of Leptospirosis Serovas N (%)L. Sejroe (60.0)L. Bratislava (22.8)L. Bangkoki (8.4)L. Pyrogenes (5.8)L. Copenhageni (2.9)L. Icterohaemorrhagia (2.9)L. Sejroe+L.Bratislava (5.8)L. Sejroe+L.Pyrogenes (2.9)total
39 Antibiotic use in hospital Antibiotic N %PGSDoxycyclinePGS + DoxycyclinePGS + 3rd cephalosporinAntibiotic use before admission 59 (48.7 %)
40 Pulmonary Hemorrhage Frank hemoptysis or bloody fluid in ET with 2 of 31. Hct drop > 3%2. CXR show alveolar infiltration with normal cardiothoracic ratio.3. No clinical congestive heart failure
41 Acute Respiratory Distress syndrome 1. No clinical of congestive heart failure: JVP < 4 cm. or CVP<12 cm.2. Gas index: PO2/FiO2 < 2003. CXR : diffuse alveolar pattern with normal cardiothoracic ratio.4. Pw < 18 cm.
42 Congestive Heart Failure 1. JVP > 5 cm. or CVP > 15 cm.2. S3 gallop or pulmonary rales3. CXR : diffuse alveolar patterncephalizationincrease cardiothoracic ratio
Your consent to our cookies if you continue to use this website.