Commonly Used Severity Scores Are Not Good Predictors of Mortality in Sepsis from Severe Leptospirosis: A Series of Ten Patients
Introduction. Severe leptospirosis, also known as Weil's disease, can cause multiorgan failure with high mortality. Scoring systems for disease severity have not been validated for leptospirosis, and there is no documented method to predict mortality. Methods. This is a case series on 10 patien...
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| Language: | English |
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Wiley
2012-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2012/532376 |
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| author | Dimitrios Velissaris Menelaos Karanikolas Nikolaos Flaris Fotini Fligou Markos Marangos Kriton S. Filos |
| author_facet | Dimitrios Velissaris Menelaos Karanikolas Nikolaos Flaris Fotini Fligou Markos Marangos Kriton S. Filos |
| author_sort | Dimitrios Velissaris |
| collection | DOAJ |
| description | Introduction. Severe leptospirosis, also known as Weil's disease, can cause multiorgan failure with high mortality. Scoring systems for disease severity have not been validated for leptospirosis, and there is no documented method to predict mortality. Methods. This is a case series on 10 patients admitted to ICU for multiorgan failure from severe leptospirosis. Data were collected retrospectively, with approval from the Institution Ethics Committee. Results. Ten patients with severe leptospirosis were admitted in the Patras University Hospital ICU in a four-year period. Although, based on SOFA scores, predicted mortality was over 80%, seven of 10 patients survived and were discharged from the hospital in good condition. There was no association between SAPS II or SOFA scores and mortality, but survivors had significantly lower APACHE II scores compared to nonsurvivors. Conclusion. Commonly used severity scores do not seem to be useful in predicting mortality in severe leptospirosis. Early ICU admission and resuscitation based on a goal-directed therapy protocol are recommended and may reduce mortality. However, this study is limited by retrospective data collection and small sample size. Data from large prospective studies are needed to validate our findings. |
| format | Article |
| id | doaj-art-a06e4d5e162a4afaad4a9ab7fe7cda84 |
| institution | OA Journals |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
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| series | Critical Care Research and Practice |
| spelling | doaj-art-a06e4d5e162a4afaad4a9ab7fe7cda842025-08-20T02:20:52ZengWileyCritical Care Research and Practice2090-13052090-13132012-01-01201210.1155/2012/532376532376Commonly Used Severity Scores Are Not Good Predictors of Mortality in Sepsis from Severe Leptospirosis: A Series of Ten PatientsDimitrios Velissaris0Menelaos Karanikolas1Nikolaos Flaris2Fotini Fligou3Markos Marangos4Kriton S. Filos5Department of Anesthesiology and Critical Care Medicine, Patras University Hospital, 26500 Rion, GreeceDepartment of Anesthesiology, Washington University School of Medicine, Campus Box 8054, 660 S. Euclid Avenue, St. Louis, MO 63110, USADepartment of Anesthesiology and Critical Care Medicine, Patras University Hospital, 26500 Rion, GreeceDepartment of Anesthesiology and Critical Care Medicine, Patras University School of Medicine, 26500 Rion, GreeceDepartment of Internal Medicine, Patras University School of Medicine, 26500 Rion, GreeceDepartment of Anesthesiology and Critical Care Medicine, Patras University School of Medicine, 26500 Rion, GreeceIntroduction. Severe leptospirosis, also known as Weil's disease, can cause multiorgan failure with high mortality. Scoring systems for disease severity have not been validated for leptospirosis, and there is no documented method to predict mortality. Methods. This is a case series on 10 patients admitted to ICU for multiorgan failure from severe leptospirosis. Data were collected retrospectively, with approval from the Institution Ethics Committee. Results. Ten patients with severe leptospirosis were admitted in the Patras University Hospital ICU in a four-year period. Although, based on SOFA scores, predicted mortality was over 80%, seven of 10 patients survived and were discharged from the hospital in good condition. There was no association between SAPS II or SOFA scores and mortality, but survivors had significantly lower APACHE II scores compared to nonsurvivors. Conclusion. Commonly used severity scores do not seem to be useful in predicting mortality in severe leptospirosis. Early ICU admission and resuscitation based on a goal-directed therapy protocol are recommended and may reduce mortality. However, this study is limited by retrospective data collection and small sample size. Data from large prospective studies are needed to validate our findings.http://dx.doi.org/10.1155/2012/532376 |
| spellingShingle | Dimitrios Velissaris Menelaos Karanikolas Nikolaos Flaris Fotini Fligou Markos Marangos Kriton S. Filos Commonly Used Severity Scores Are Not Good Predictors of Mortality in Sepsis from Severe Leptospirosis: A Series of Ten Patients Critical Care Research and Practice |
| title | Commonly Used Severity Scores Are Not Good Predictors of Mortality in Sepsis from Severe Leptospirosis: A Series of Ten Patients |
| title_full | Commonly Used Severity Scores Are Not Good Predictors of Mortality in Sepsis from Severe Leptospirosis: A Series of Ten Patients |
| title_fullStr | Commonly Used Severity Scores Are Not Good Predictors of Mortality in Sepsis from Severe Leptospirosis: A Series of Ten Patients |
| title_full_unstemmed | Commonly Used Severity Scores Are Not Good Predictors of Mortality in Sepsis from Severe Leptospirosis: A Series of Ten Patients |
| title_short | Commonly Used Severity Scores Are Not Good Predictors of Mortality in Sepsis from Severe Leptospirosis: A Series of Ten Patients |
| title_sort | commonly used severity scores are not good predictors of mortality in sepsis from severe leptospirosis a series of ten patients |
| url | http://dx.doi.org/10.1155/2012/532376 |
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