Okolhere et al reported factors associated with a worse outcome for a patient with Lassa fever. These can help to identify a patient who may require more aggressive management. The authors are from Irrua Specialist Teaching Hospital (Nigeria), Ambrose Alli University (Nigeria), Harvard University, Howard Hughes Medical Institute and University of California Los Angeles.
Patient selection: Lassa fever
Predictors for worse outcome (from multivariate analysis):
(1) older age (increase in mortality 1.4 times for each 10 years over 50 years of age)
(2) acute kidney injury (OR 1.3 for elevated serum creatinine)
(3) severe CNS manifestations (OR 2.75)
(4) elevated serum AST (OR 1.5)
(5) hyperkalemia (OR 3.6)
(6) failure to normalize serum creatinine
(7) jaundice (OR 7.6)
(8) bleeding (OR (2.5)
Manifestations of acute kidney injury:
(1) proteinuria
(2) hematuria
(3) higher mean serum potassium
(4) low BUN-to-creatinine ratio
(5) increase in serum creatinine
