Clinical Study
American Visceral Leishmaniasis: Factors Associated with Lethality in the State of São Paulo, Brazil
Table 3
Statistical analysis of factors associated with VL lethality, state of Sao Paulo, 1999–2005 (bivariate analysis).
| | Outcome ( = 376) | | |
Features | Death | Cured | Total | OR (95% CI) | value | | | | | | |
| Signs and symptoms | | | | | | Asthenia | 44 | 191 | 235 | 3.38 (1.59–7.16) | 0.0008 | Cardiac abnormality | 9 | 10 | 19 | 6.53 (2.28–18.65) | <0.0001 | Dehydration | 12 | 8 | 20 | 12.11 (4.66–31.47) | <0.0001 | Diarrhea | 20 | 52 | 72 | 3.16 (1.68–5.93) | 0.0002 | Dyspnea | 12 | 22 | 34 | 4.00 (1.84–8.69) | 0.0001 | Edema | 10 | 11 | 21 | 6.75 (2.7–16.86) | <0.0001 | Hemorrhagic manifestation | 18 | 22 | 40 | 7.24 (3.54–14.83) | <0.0001 | Jaundice | 10 | 6 | 16 | 12.88 (4.45–37.31) | <0.0001 | Pallor | 39 | 199 | 238 | 2.02 (1.02–4.01) | 0.040 | Dry Cough | 29 | 127 | 156 | 1.86 (1.04–3.35) | 0.035 | Vomiting | 13 | 35 | 48 | 2.67 (1.30–5.48) | 0.006 | Drowsiness | 9 | 11 | 20 | 5.8 (2.27–14.79) | <0.0001 |
| Laboratory analysis | | | | | | Total bilirubin ≥ 2.0 | 13 | 6 | 19 | 17.17 (6.18–47.7) | <0.0001 | Hypoalbuminemia ≤ 3.0 | 15 | 37 | 52 | 3.05 (1.53–6.07) | 0.0009 | Thrombocytopenia ≤ 100.000 | 31 | 108 | 139 | 2.8 (1.55–5.08) | 0.0004 | Aspartate aminotransferase > 40 | 20 | 62 | 82 | 2.55 (1.37–4.74) | 0.002 |
| Comorbidities | | | | | | Liver disease | 3 | 2 | 5 | 9.79 (1.59–60.11) | 0.020 | Diabetes | 5 | 4 | 9 | 8.46 (2.19–32.62) | 0.003 | Peripheral vascular disease | 7 | 5 | 12 | 9.86 (3.0–32.4) | <0.0001 | Splenectomy | 2 | 0 | 2 | undefined | 0.019 | Congestive heart failure | 4 | 2 | 6 | 13.33 (2.38–74.78) | 0.004 | Use of immunosuppressive drugs | 3 | 0 | 3 | undefined | 0.002 | Tuberculosis | 3 | 1 | 4 | 19.65 (2.0–192.74) | 0.009 |
| Fever | | | | | | ≥60 days | 13 | 26 | 39 | 3.71 (1.76–7.80) | 0.0002 | ≥30 days | 26 | 79 | 105 | 2.97 (1.64–5.39) | 0.0002 |
| Age | | | | | | ≥30 years | 36 | 73 | 109 | 7.25 (3.85–13.66) | <0.0001 | ≥50 years | 28 | 17 | 45 | 20.16 (9.74–41.73) | <0.0001 |
| Complications | 53 | 64 | 117 | undefined | <0.0001 | Opportunistic infections | 21 | 43 | 64 | 4.27 (2.26–8.08) | <0.0001 | Pneumonia | 13 | 29 | 42 | 0.40 (0.18–0.89) | 0.023 | Bleeding | 24 | 2 | 26 | 26.1 (5.77–117.78) | <0.0001 | Sepsis | 28 | 0 | 28 | undefined | <0.0001 | Antimicrobial use | 34 | 59 | 93 | 8.71 (4.56–16.64) | <0.0001 | Blood derivatives | 36 | 95 | 131 | 5.61 (2.93–10.72) | <0.0001 |
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