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Revista Cubana de Medicina

versión impresa ISSN 0034-7523versión On-line ISSN 1561-302X

Resumen

CAO PAREDES, Ivette Tamara et al. Behavior of severe leptospirosis at the intensive care unit. Rev cubana med [online]. 2004, vol.43, n.4. ISSN 0034-7523.

The behavior of severe leptospirosis in 35 patients admitted at the Adults' Intensive Care Unit of "Dr. Luis Díaz Soto" Institute of Military Medicine was described. Data were taken from the medical records of those patients, whose diagnosis had been confirmed by serological tests. Univariate analysis was made for each variable by Student's t test and Chi square test. The logistical regression method was used to determine factors associated with mortality. 20 % of the persons with severe leptospirosis died .No significant relation was found between having animals, or living in a rural area and mortality. 71.4 % of the diagnositc errors in the group of deaths were proved. Urinary sepsis was the main of them. The prognostic factors showing the highest relation with mortality (p < 0.05; 95 % of confidence) were: a) days of onset of the symptoms, b) stay at the AICU, c) ratio PO2/FiO2, f) APACHE II value, g) requirement of inotropic drugs, h) presence of acute renal failure. i) existance of coagulopathies, j) demand of globules transfusions, k) need of extrarenal depuration, l) manifestations of multiple organ dysfunction. It was concluded that leptospirosis behaved as a medical emergency and that the severe patient care service should give it an appropriate attention.

Palabras clave : Severe leptospirosis; severe sepsis; prognostic factors.

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