Predictors of In-hospital Mortality In Patients With RT-PCR Confirmed Lassa Fever Infection Treated At A National Treatment Center, South West Nigeria

Abstract

Background: Lassa fever (LF) infection is one of the viral hemorrhagic fever diseases found mainly in Sub-Saharan West Africa, including Nigeria. The case fatality rate is 60% among patients with Lassa fever complicated by AKI in one center study in Nigeria. Clinical and laboratory parameter has been documented as predictors of mortality among confirmed Lassa fever infected patients. Therefore, we decided to conduct similar study in our hospital to determine predictors of inhospital mortality among Lassa fever infected patients. Aim: This study was designed to determine the in-hospital clinical and laboratory predictors of outcome among RT-PCR (Real Time- Polymerase Chain Reaction) diagnosed Lassa fever patients. Methodology: This was a descriptive retrospective study involving the assessment of records of confirmed LF infected patients that were managed at the center from December 2019 to December 2020. 147 medical case record files of patients were retrieved for this study. Results: We found in our hospital setting, altered sensorium (p=0.001), seizures (p=0.001), bleeding diathesis (p=0.001), oliguria (p=0.001), elevated urea (p=0.001), elevated creatinine (p=0.001), hypoalbuminaemia (P=0.001), elevated SGOT (P=0.008) as significant predictors on in-hospital mortality. Conclusion: This study has helped us to identify the clinical parameters such as bleeding, central nervous system affectation, oliguria, tachycardia, tachypnea, hypoxaemia and laboratory parameters such as, elevated urea, elevated creatinine, hypoalbuminaemia as predictors of in-hospital mortality in RT-PCR confirmed Lassa fever patients. We believe early recognition of derangements of these parameters and with prompt intervention shall help to improve standards of care and outcome.