Table 1. Characteristics of clinical management of fatal and non-fatal leptospirosis patients, Puerto Rico, 2010.
| Fatal cases | Non-fatal controls | ||
|---|---|---|---|
| N = 21 | N = 52 | ||
| n (%) | n (%) | P-value | |
| Medications taken before first seeking care | |||
| Acetaminophen | 9 (42.9) | 16 (30.8) | 0.42 |
| Antibiotic | 0 (0.0) | 5 (9.6) | 0.33 |
| Other* | 7 (33.3) | 11 (21.2) | 0.38 |
| First medical visit | |||
| DPO, median (range) | 2.5 (0–10) | 5 (2–14) | <0.01 |
| Facility type | |||
| Private Clinic | 2 (9.5) | 2 (3.9) | 0.62 |
| Out-patient clinic | 8 (38.1) | 2 (3.9) | Reference |
| Hospital | 11 (52.4) | 47 (92.2) | <0.01 |
| Outcome | |||
| Sent home | 8 (38.1) | 44 (84.6) | <0.01 |
| Admitted or referred for admission | 13 (61.9) | 8 (15.4) | Reference |
| Hospitalization | |||
| DPO admitted | 4.5 (2–10) | 6 (2–14) | 0.31 |
| Duration of hospitalization in days, median (range) | 4 (1–37) | 8 (0–150) | 0.68 |
| Admitted to intensive care unit | 16 (76.2) | 21 (40.4) | 0.01 |
| Intubated | 19 (90.5) | 7 (13.5) | <0.01 |
| Hemodialysis initiated | 7 (33.3) | 4 (7.7) | 0.02 |
| Received a blood product† | 13 (61.9) | 28 (53.8) | 0.57 |
| Diagnosis | |||
| “Leptospirosis” in differential at first medical visit | 9 (42.9) | 5 (9.6) | 0.01 |
| “Dengue” or “viral syndrome” in differential at first medical visit | 15 (71.4) | 31 (59.6) | 0.25 |
| “Leptospirosis” in discharge diagnosis at first medical visit | 4 (19.0) | 14 (26.9) | 0.76 |
| “Dengue” or “viral syndrome” in discharge diagnosis at first medical visit | 7 (33.3) | 26 (50.0) | 0.18 |
| “Leptospirosis” mentioned in any medical record | 18 (85.7) | 31 (59.6) | 0.03 |
| DPO first mentioned, median (range) | 5 (2–10) | 7 (2–26) | 0.09 |
| DPH first mentioned, median (range) | 0.5 (0–20) | 1 (0–15) | 0.30 |
| “Dengue” mentioned in any medical record | 15 (71.4) | 52 (100) | <0.01 |
| DPO first mentioned, median (range) | 3 (1–11) | 5 (2–14) | 0.23 |
| DPH first mentioned, median (range) | 0 (0–4) | 0 (0–2) | 0.08 |
| Medications | |||
| Penicillin-derivative antibiotic | 19 (90.5) | 38 (73.1) | 0.62 |
| DPO given, median (range) | 4.5 (3–10) | 6.0 (3–13) | 0.23 |
| DPH given, median (range) | 1 (0–3) | 1.0 (0–6) | 0.73 |
| Corticosteroid | 9 (42.9) | 33 (63.5) | 0.82 |
| DPO given, median (range) | 4 (1–7) | 6.0 (2–14) | 0.20 |
| DPH given, median (range) | 0 (0–2) | 0 (0–4) | 0.58 |
*Other = aspirin, non-steroidal anti-inflammatory drug, statin, anti-depressant, anti-histamine, histamine H2R antagonist, nitrate, sulfonylurea
†Cases: 8 (38%) received platelets, 5 (24%) received packed red blood cells, and 4 (19%) received fresh frozen plasma; Controls: 18 (35%) received platelets, 15 (29%) received packed red blood cells, 2 (4%) received fresh frozen plasma, and 1 (2%) received plasma.
Abbreviations: DPO = day post-illness onset; DPH = day post-illness onset of hospitalization; N = Normal