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成人钩端螺旋体病相关急性肾损伤(LAKI)的死亡率及其发病的预测因素:系统评价。

Mortality of leptospirosis associated acute kidney injury (LAKI) & predictors for its development in adults: A systematic review.

机构信息

Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Malaysia; Department of Clinical Sciences, Ajman University, Ajman, United Arab Emirates.

Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Malaysia.

出版信息

J Infect Public Health. 2019 Nov-Dec;12(6):751-759. doi: 10.1016/j.jiph.2019.06.014. Epub 2019 Jul 4.

Abstract

Leptospirosis is the most widely spread zoonosis and Leptospirosis Associated Acute Kidney Injury (LAKI) is common and fatal if not properly and swiftly treated. The aim of this review is to evaluate the mortality of LAKI and to identify the risk factors for its development. An electronic search was performed to identify the studies included LAKI patients series. Only studies which investigated mortality or risk factors for LAKI development in adults were included. Twenty-three studies with 24 patients series were included in the final analysis and included 1698 patients. The median series mortality was 10.05% (range 0-33.3%) with a total of 223 death. Only four studies identified the independent risk factors for LAKI development which were oliguria, jaundice, arrhythmia, crackles, elevated direct bilirubin level, elevated activated prothrombin time, hyperbilirubinemia and leukocytosis. Although the mortality of LAKI is high, its predictors are not studied enough in literature.

摘要

钩端螺旋体病是最广泛传播的动物源性传染病,如果不及时、迅速地治疗,钩端螺旋体病相关急性肾损伤(LAKI)很常见且致命。本综述的目的是评估 LAKI 的死亡率,并确定其发病的危险因素。进行了电子检索以确定纳入 LAKI 患者系列的研究。仅纳入了调查成人 LAKI 死亡率或发病危险因素的研究。最终分析纳入了 23 项研究和 24 个患者系列,共纳入 1698 例患者。中位系列死亡率为 10.05%(范围 0-33.3%),共有 223 例死亡。仅有 4 项研究确定了 LAKI 发病的独立危险因素,分别为少尿、黄疸、心律失常、湿啰音、直接胆红素升高、活化部分凝血活酶时间升高、高胆红素血症和白细胞增多。尽管 LAKI 的死亡率很高,但文献中对其预测因素的研究还不够充分。

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