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Volume 18, Number 4—April 2012


Identification of Risk Factors for Chronic Q Fever, the Netherlands

Linda M. KampschreurComments to Author , Sandra Dekker, Julia C.J.P. Hagenaars, Peter J. Lestrade, Nicole H.M. Renders, Monique G.L. de Jager-Leclercq, Mirjam H.A. Hermans, Cornelis A.R. Groot, Rolf H.H. Groenwold, Andy I.M. Hoepelman, Peter C. Wever, and Jan Jelrik Oosterheert
Author affiliations: University Medical Centre Utrecht, Utrecht, the Netherlands (L.M. Kampschreur, R.H.H. Groenwold, A.I.M Hoepelman, J.J. Oosterheert); VU University, Amsterdam, the Netherlands (S. Dekker); Jeroen Bosch Hospital, ’s-Hertogenbosch, the Netherlands (J.C.J.P. Hagenaars, P.J. Lestrade, N.H.M. Renders, M.H.A. Hermans, P.C. Wever); Bernhoven Hospital, Oss/Veghel, the Netherlands (M.G.L. de Jager-Leclercq, C.A.R. Groot)

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Table 3

Results of multivariate analyses of risk factors for development of chronic Q fever, the Netherlands*

Risk factor*† All chronic Q fever

Proven and probable chronic Q fever

Proven chronic Q fever
OR (95% CI) p value OR (95% CI) p value OR (95% CI) p value
Valvular surgery†‡ 31.5 (3.99–249) 0.001 47.7 (5.87–387) 0.000 43.6 (4.70–405) 0.001
Vascular prosthesis‡§ 10.4 (2.17–50.0) 0.003 14.9 (2.96–75.2) 0.001 26.8 (4.88–147) 0.000
Aneurysm§¶ 8.65 (1.74–42.9) 0.008 13.5 (2.60–70.4) 0.002 25.9 (4.55–147) 0.000
Renal insufficiency¶# 9.08 (1.44–57.2) 0.019 16.0 (2.06–123) 0.008
Nonhematologic malignancy 3.90 (1.33–11.5) 0.013
Age, continuous 1.03 (1.01–1.06)# 0.005 1.06 (1.03–1.09)# 0.000 1.06 (1.02–1.11)# 0.005

*OR, odds ratio.
†Possible risk factors entered in all analyses: age, vascular prosthesis, aortic aneurysm, other vascular surgeries, peripheral arterial disease, cerebrovascular disease, valvular surgery, valvular disease (nonsurgical), ischemic cardiac disease, other cardiac history, hypertension, dyslipidemia, diabetes, nonhematologic malignancy, renal insufficiency. Immune disorder was also entered in the analyses of proven and probable chronic Q fever and of proven chronic Q fever. Pacemaker was also entered in the analysis of proven chronic Q fever.
‡Valvular surgeries in the proven group are subdivided into biological valve (n = 6), prosthetic valve (n = 3), and valve repair (n = 1) all located in the aortic valve (n = 10). Within the controls there were no patients with history of valvular surgery.
§Locations of vascular prostheses in proven group were infrarenal and iliac (n = 6), infrarenal (n = 4), thoracic (n = 2), and unknown (n = 2). Types of vascular prosthesis were Y-prosthesis (n = 7), endovascular aneurysm repair (n = 2), stent graft (n = 2), Bentall (n = 1), and unknown (n = 2). For the 2 control patients, specifications of the prostheses were unknown.
¶Locations of aneurysms in proven group were infrarenal (n = 6), infrarenal and iliac (n = 2), and suprarenal, infrarenal, and iliac (n = 1). Within the control group, aneurysms were infrarenal and iliac (n = 2).
#Observed stages of chronic kidney disease according to the Kidney Disease Outcome Quality Initiative guidelines (28) in the proven group were stage 3 (n = 6), stage 4 (n = 2), and stage 5 (n = 1) and in the controls solely stage 3 (n = 2).
#OR per year of increasing age.

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