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Critical Care

, 5:P096 | Cite as

Multiorgan failure in malaria: what we have learned over the past 10 years

  • B Zeippen
  • I Joubert
  • C O'Reilly
Meeting abstract
  • 834 Downloads

Keywords

Public Health Intensive Care Unit Renal Failure Malaria High Mortality 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Objectives

Incidence and outcome of multiorgan failure in Severe Malaria. Usefulness of severity of disease scoring systems.

Design and methods

This is a retrospective analysis of data from 152 patients admitted to the Intensive Care Unit at the Chris Hani Baragwanath Hospital between 1990 and 1999 with a confirmed diagnosis of Severe Malaria.

Results

Of the 152 patients, 81 (53.3%) were male and 71 (46.7%) female. The overall mortality was 31.6% (48/152).

Conclusions

The occurrence of acute renal failure in malaria is an ominous event even when it occurs on its own. ARDS is however a serious complication which carries a high mortality. The combination of ARF together with ARDS has an almost universally fatal outcome. APACHE II score, SOFA score and WHO criteria correlate closely with outcome.
Table 1

Demographics

 

All

(n = 152)

Alive

(n = 104)

Dead

(n = 48)

 
 

Median

Range

Median

Range

Median

Range

P value

Age (years)

32.5

14-71

32

14-67

34

17-71

NS

Apache II

17

1-43

15

1-30

22

9-43

< 0.005

WHO

5

0-12

4.5

0-10

8

3-12

< 0.005

Parasitaemia (%)

11

< 1-71

11

< 1-56

12

< 1-71

NS

SOFA

10

0-18

9

0-17

12

6-18

< 0.005

ICU stay (days)

4

< 1-80

4

1-37

4

< 1-80

NS

Hemoglobin (g/dl)

9.2

3.2-16

9.6

4.3-16

8.5

3.2-15

NS

Platelet count (× 103/dl)

41

4-300

42.5

4-300

36

7-96

< 0.005

Table 2

Organ failure: incidence and outcome

 

ARDS

ARF with CVVHD

ARDS & ARF

Mortality

Y

N

 

Y

N

 

Both

None

 

Number

31

121

(20.4%)

75

77

(49%)

24

70

(16/46%)

Mortality (%)

80.6

19.4

P < 0.000

52

11.7

P < 0.000

87.5

7.1

P < 0.000

Copyright information

© The Author(s) 2001

Authors and Affiliations

  • B Zeippen
    • 1
  • I Joubert
    • 1
  • C O'Reilly
    • 1
  1. 1.Intensive Care Unit, Chris Hani Baragwanath HospitalUniversity of the WitwatersrandSowetoRSA

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