Volume 24, Number 6—June 2018
CME ACTIVITY - Research
Bioclinical Test to Predict Nephropathia Epidemica Severity at Hospital Admission
, Stéphanie Mestrallet, Pascale Halin, Laure-Anne Pannet, Delphine Lebrun, Moustapha Dramé, Firouzé Bani-Sadr, Jean-Marc Galempoix, Christophe Strady, Jean-Marc Reynes, Christian Penalba, and Amélie Servettaz
Table 2
Univariable and multivariable analysis of factors predictive of severe nephropathia epidemica, Ardennes Department, France, January 2000–December 2014*
| Category |
Univariable analysis, n = 205 | Multivariable analysis,† n = 194 | ||||
|---|---|---|---|---|---|---|
| OR‡ (95% CI) |
p value |
Missing |
aOR (95% CI) |
p value |
||
| Age >40 y | 0.63 (0.31–1.27) | 0.19 | 0 | |||
| Female sex | 0.80 (0.37–1.76) | 0.58 | 0 | |||
| Charlson comorbidity index score >1 | 0.68 (0.22–2.11) | 0.51 | 0 | |||
| Nephrotoxic drug intake | 2.12 (1.06–4.23) | 0.03 | 0 | 3.25 (1.42–7.46) | 0.005 | |
| Chronic renal disease | 1.19 (0.12–11.72) | 0.88 | 0 | |||
| Low back pain | 1.38 (0.71–2.68) | 0.34 | 0 | |||
| Visual disorders | 3.01 (1.53–5.20) | 0.002 | 0 | 2.64 (1.17–5.96) | 0.02 | |
| Microscopic or macroscopic hematuria | 2.54 (1.26–5.11) | 0.009 | 6 | 2.37 (1.03–5.43) | 0.04 | |
| Platelet count <90 × 109/L | 3.15 (1.53–6.46) | 0.002 | 1 | 3.74 (1.59–8.81) | 0.003 | |
| Leukocyte count >10 × 109 cells/L | 2.87 (1.36–6.05) | 0.006 | 5 | 3.03 (1.25–7.39) | 0.01 | |
| C-reactive protein >100 mg/L, >952 nmol/L | 2.19 (1.12–4.31) | 0.02 | 2 | |||
| Alanine aminotransferase >1 × ULN | 1.66 (0.76–3.59) | 0.20 | 28 | |||
| Aspartate aminotransferase >1 × ULN | 1.18 (0.53–2.61) | 0.69 | 26 | |||
*aOR, adjusted odds ratio; OR, odds ratio; ULN, upper limit of normal.
†The multivariable model was systematically adjusted for the time between onset of symptoms and hospitalization. The C statistic for the multivariable model was 0.81. Hosmer-Lemeshow goodness-of-fit test: p = 0.87.
‡Logarithm for odds of severe nephropathia epidemica = −3.0830 − (0.1214 × days between first symptoms and hospitalization) + (0.9693 × visual disorder) + (0.8621 × hematuria) + (1.1099 × elevated leukocyte count) + (1.3185 × thrombocytopenia) + (1.1787 × nephrotoxic drug exposure).
§Nephrotoxic drugs included nonsteroidal antiinflammatory drugs, iodinated contrast media, diuretics, renin angiotensin aldosterone system inhibitors, and nephrotoxic antimicrobial drugs (aminoglycosides, glycopeptides).