Scholarly Article
ORGAN-SYSTEM COMPLICATIONS AND THEIR ASSOCIATION WITH MORTALITY IN SEVERE LEPTOSPIROSIS: A PROSPECTIVE OBSERVATIONAL STUDY
K, Harika, Mithun N. Kagalkar, Radha A
2026-06-30 · International Journal of Clinical and Biomedical Research · Sumathi Publications
Abstract
Background: Severe leptospirosis involves multiple organ systems, and the relative contribution of each to mortality is not well quantified in Indian cohorts. Methods: In this prospective, single-centre observational study conducted over 24 months (2018-2020), 85 patients aged 18-70 years with leptospirosis diagnosed by modified Faine's criteria were enrolled. Renal, pulmonary, hepatic and neurological complications, and the organ-supportive interventions they required, were related to in-hospital outcome using Fisher's exact test. Results: In-hospital mortality was 27.1% (23/85). Renal impairment (creatinine >1 mg/dL) affected 73 patients (85.9%); mortality rose across creatinine strata from 8.3% ( 3) (p for trend = 0.001). Hypoxia occurred in 36 patients (42.4%), of whom 33 (91.7%) had ARDS. Hepatitis was the commonest complication (45 patients, 52.9%) and was associated with death (42.2% versus 10.0%; odds ratio [OR] 6.43, 95% confidence interval [CI] 1.84-29.11; p=0.001). Neurological events occurred in 10 patients (11.8%) and carried the highest complication-specific mortality (70.0% versus 21.3%; OR 8.32, 95% CI 1.67-55.55; p=0.003). Mortality was far higher again among patients needing organ support: 87.5% of those dialysed (OR 25.4), 90.0% of those requiring inotropes (OR 95.1) and 94.7% of those invasively ventilated (OR 188.8); p≤0.001 for all. Conclusion: Multi-organ involvement is common in severe leptospirosis. Mortality escalated far more steeply once a complication required active organ support than with the presence of the complication itself. Neurological involvement, though least common, carried the highest complication-specific mortality.
Keywords
Leptospirosis, Acute kidney injury, ARDS, neurological complications, Hepatitis, Multi-organ dysfunction, Mortality
Citation Details
International Journal of Clinical and Biomedical Research, Vol. 11, No. 2, pp. 233-240