van Griensven J, Bah EI, Haba N, Delamou A, Camara BS, Olivier KJJ, De Clerck H, Nordenstedt H, Semple MG, Van Herp M, Buyze J, De Crop M, Van Den Broucke S, Lynen L, De Weggheleire A. Electrolyte and Metabolic Disturbances in Ebola Patients during a Clinical Trial, Guinea, 2015.
Emerg Infect Dis 2018;
22. [PMID:
27869610 PMCID:
PMC5189166 DOI:
10.3201/eid2212.161136]
[Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Such abnormalities were common during infection and enabled accurate stratification of the risk for death.
Electrolyte and Metabolic Disturbances in Ebola
By using data from a 2015 clinical trial on Ebola convalescent-phase plasma in Guinea, we assessed the prevalence of electrolyte and metabolic abnormalities at admission and their predictive value to stratify patients into risk groups. Patients underwent testing with a point-of-care device. We used logistic regression to construct a prognostic model and summarized the predictive value with the area under the receiver operating curve. Abnormalities were common among patients, particularly hypokalemia, hypocalcemia, hyponatremia, raised creatinine, high anion gap, and anemia. Besides age and PCR cycle threshold value, renal dysfunction, low calcium levels, and low hemoglobin levels were independently associated with increased risk for death. A prognostic model using all 5 factors was highly discriminatory (area under the receiver operating curve 0.95; 95% CI 0.90–0.99) and enabled the definition of risk criteria to guide targeted care. Most patients had a very low (<5%) or very high (>80%) risk for death.
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