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 (𝑛 = 376)
Features	Death	Cured	Total	OR (95% CI)	𝑃 value
	𝑛=53	𝑛=323	𝑛=376
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