Developing a Clinically Relevant Classification to Predict Mortality in Severe Leptospirosis

Overview

Journal J Emerg Trauma Shock

Specialty Emergency Medicine

Date 2010 Oct 9

PMID 20930963

Citations 10

Authors

Senaka Rajapakse

Chaturaka Rodrigo

Rashan Haniffa

Affiliations

Soon will be listed here.

Abstract

Background: Severe leptospirosis requires critical care and has a high mortality. We reviewed the literature to identify factors predicting mortality, and such predictors were classified according to the predisposition, infection, response, organ dysfunction (PIRO) concept, which is a risk stratification model used in severe sepsis.

Material And Methods: PUBMED was searched for all articles (English), with the key word leptospirosis in any field, within the last 20 years. Data were collected from 45 relevant papers and grouped into each component of the PIRO model.

Results: THE FOLLOWING CORRELATED WITH INCREASED MORTALITY: predisposition - increasing age and chronic alcoholism; infection - leptospiraemic burden; response - hemodynamic disturbances, leukocytosis; organ dysfunction - multiple organ dysfunction syndrome, pulmonary involvement and acute renal failure.

Conclusions: Further research is needed to identify the role of infecting serovars, clinical signs, inflammatory markers, cytokines and evidence of hepatic dysfunction as prognostic indicators. It is hoped that this paper will be an initiative to create a staging system for severity of leptospirosis based on the PIRO model with an added component for treatment-related predictors.

Citing Articles

Determinants of prolonged hospitalization and mortality among leptospirosis patients attending tertiary care hospitals in northeastern state in peninsular Malaysia: A cross sectional retrospective analysis.

Al Hariri Y, Sulaiman S, Khan A, Adnan A, Al-Ebrahem S Front Med (Lausanne). 2022; 9:887292.

PMID: 36160172 PMC: 9500579. DOI: 10.3389/fmed.2022.887292.

A simple score to predict severe leptospirosis.

Smith S, Kennedy B, Dermedgoglou A, Poulgrain S, Paavola M, Minto T PLoS Negl Trop Dis. 2019; 13(2):e0007205.

PMID: 30759081 PMC: 6391019. DOI: 10.1371/journal.pntd.0007205.

Leptospirosis presenting as severe cardiogenic shock: A case report.

Forbat E, Rouhani M, Pavitt C, Patel S, Handslip R, Ledot S J Intensive Care Soc. 2018; 19(4):351-353.

PMID: 30505346 PMC: 6259084. DOI: 10.1177/1751143718754993.

Animal Models of Leptospirosis: Of Mice and Hamsters.

Gomes-Solecki M, Santecchia I, Werts C Front Immunol. 2017; 8:58.

PMID: 28270811 PMC: 5318464. DOI: 10.3389/fimmu.2017.00058.

Utility of modified Faine's criteria in diagnosis of leptospirosis.

Bandara K, Weerasekera M, Gunasekara C, Ranasinghe N, Marasinghe C, Fernando N BMC Infect Dis. 2016; 16(1):446.

PMID: 27554098 PMC: 4995749. DOI: 10.1186/s12879-016-1791-9.

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