Predictors of lethality in severe leptospirosis in Transcarpathian region of Ukraine

Abstract

Leptospirosis is one of the most widespread zoonoses in the Transcarpathian region, with an average lethality of 12.5%. To determine the predictors of lethality, a retrospective study of 97 medical records of patients with leptospirosis in the period from 2009 to 2018 was conducted. Quantitative variables in the presence of normal distribution were compared using a paired Student's t-test, and in the case of an abnormal distribution, the Mann-Whitney U test was used. The criterion χ2 was used for qualitative variables. Multivariate analysis was used for the calculation of the Odds ratio. The following factors that are associated with death from leptospirosis have been identified: total bilirubin greater than 300 mcmol/L (OR, 4.25; 95% confidence interval [CI], 1.57-11.53), platelets less than 50 × (109/L) (OR, 3.95; 95% confidence interval [CI], 1.45-10.73), creatinine above 200 mcmol/L (OR, 1.95; 95% confidence interval [CI], 1.47-2.60) and jaundice (OR, 1.39; 95% confidence interval [CI], 1.21-1.60). Detection of these predictors will help to quickly identify a patient at risk of severe course of the disease and death, which will allow deciding on the use of early intensive care.