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dc.contributor.authorSmith, Simonen
dc.contributor.authorKennedy, Brendan Jen
dc.contributor.authorDermedgoglou, Alexisen
dc.contributor.authorPoulgrain, Suzanne Sen
dc.contributor.authorPaavola, Matthew Pen
dc.contributor.authorMinto, Tarryn Len
dc.contributor.authorLuc, Michaelen
dc.contributor.authorLiu, Yu-Hsuanen
dc.contributor.authorHanson, Joshen
dc.date.accessioned2023-11-01T00:28:34Z-
dc.date.available2023-11-01T00:28:34Z-
dc.date.issued2019-
dc.identifier.citationSmith S, Kennedy BJ, Dermedgoglou A, Poulgrain SS, Paavola MP, Minto TL, Luc M, Liu YH, Hanson J. A simple score to predict severe leptospirosis. PLoS Negl Trop Dis. 2019 Feb 13;13(2):e0007205. doi: 10.1371/journal.pntd.0007205. PMID: 30759081; PMCID: PMC6391019.en
dc.identifier.urihttps://dora.health.qld.gov.au/qldresearchjspui/handle/1/5417-
dc.descriptionCairns & Hinterland Hospital and Health Service (CHHHS) affiliated authors: Simon Smith, Alexis Dermedgoglou, Suzanne S. Poulgrain, Matthew P. Paavola, Tarryn L. Minto, Michael Luc, Yu-Hsuan Liu, Josh Hansonen
dc.description.abstractThe case-fatality rate of severe leptospirosis can exceed 50%. While prompt supportive care can improve survival, predicting those at risk of developing severe disease is challenging, particularly in settings with limited diagnostic support. We retrospectively identified all adults with laboratory-confirmed leptospirosis in Far North Queensland, Australia, between January 1998 and May 2016. Clinical, laboratory and radiological findings at presentation were correlated with the patients' subsequent clinical course. Medical records were available in 402 patients; 50 (12%) had severe disease. The presence of oliguria (urine output ≤500 mL/24 hours, odds ratio (OR): 16.4, 95% confidence interval (CI): 6.9-38.8, p<0.001), abnormal auscultatory findings on respiratory examination (OR 11.2 (95% CI: 4.7-26.5, p<0.001) and hypotension (systolic blood pressure ≤100 mmHg, OR 4.3 (95% CI 1.7-10.7, p = 0.002) at presentation independently predicted severe disease. A three-point score (the SPiRO score) was devised using these three clinical variables, with one point awarded for each. A score could be calculated in 392 (98%) patients; the likelihood of severe disease rose incrementally: 8/287 (3%), 14/70 (20%), 18/26 (69%) and 9/9 (100%) for a score of 0, 1, 2 and 3 respectively (p = 0.0001). A SPiRO score <1 had a negative predictive value for severe disease of 97% (95% CI: 95-99%). A simple, three-point clinical score can help clinicians rapidly identify patients at risk of developing severe leptospirosis, prompting early transfer to referral centres for advanced supportive care. This inexpensive, bedside assessment requires minimal training and may have significant utility in the resource-limited settings which bear the greatest burden of disease.en
dc.language.isoenen
dc.relation.ispartofPLoS neglected tropical diseasesen
dc.subjectLeptospirosisen
dc.subjectHypotensionen
dc.subjectHemorrhageen
dc.subjectMedical risk factorsen
dc.subjectAustraliaen
dc.subjectCreatinineen
dc.subjectBlood pressureen
dc.subjectClinical laboratoriesen
dc.titleA simple score to predict severe leptospirosisen
dc.typeArticleen
dc.identifier.doi10.1371/journal.pntd.0007205-
dc.identifier.pmid30759081-
item.fulltextWith Fulltext-
item.grantfulltextopen-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.languageiso639-1en-
item.openairetypeArticle-
Appears in Sites:Cairns & Hinterland HHS Publications
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