Imported severe malaria and risk factors for intensive care: A single-centre retrospective analysis

• Published in: PloS one Vol. 14; no. 11; p. e0225135
• Main Authors: D'Abramo, Alessandra, Lepore, Luciana, Iannetta, Marco, Gebremeskel Tekle, Saba, Corpolongo, Angela, Scorzolini, Laura, Bevilacqua, Nazario, Mariano, Andrea, Giancola, Maria Letizia, Vulcano, Antonella, Maritti, Micaela, Agresta, Alessandro, Antonini, Mario, D'Alessandro, Umberto, Nicastri, Emanuele
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 14.11.2019; Public Library of Science (PLoS)
• Subjects: Adult; Aspartate; Aspartate aminotransferase; Biology and Life Sciences; Coma; Communicable diseases; Communicable Diseases, Imported - diagnosis; Communicable Diseases, Imported - epidemiology; Communicable Diseases, Imported - parasitology; Comorbidity; Complications; Critical Care; Failure analysis; Fatalities; Female; Health risks; Hospital patients; Hospitalization; Hospitals; Humans; Infectious diseases; Intensive care; Intensive Care Units; International trade; Malaria; Malaria - diagnosis; Malaria - epidemiology; Malaria - parasitology; Malaria - transmission; Male; Medical research; Medicine and Health Sciences; Methicillin; Middle Aged; Mortality; Multivariate analysis; Parasites; Patients; Physical Sciences; Public health; Research and Analysis Methods; Retrospective Studies; Risk analysis; Risk Factors; Rome - epidemiology; Sepsis; Severity of Illness Index; Tropical diseases; Vector-borne diseases; World health; Rome; Gambia; Italy; India
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0225135

This study aims to identify the risk factors for intensive care (IC) in severe malaria patients admitted to the "Lazzaro Spallanzani" National Institute for Infectious Diseases, Rome, Italy. All patients with confirmed severe malaria and hospitalized between 2007 and 2015 were included in the analysis and stratified into two groups: those requiring IC and those who did not. Five prognostic malaria scores were estimated; clinical severity at IC unit admission was assessed using the Sequential Organ Failure Assessment and the quick-Sequential Organ Failure Assessment scores. Univariate and multivariate analysis were performed to assess factors independently associated to IC. A total of 98 severe malaria patients were included; 10 of them required IC. There were no deaths or sequelae. Patients requiring IC had higher severity scores. At the multivariate analysis, only the number of World Health Organization criteria and the aspartate aminotransferase value were independently associated with the need of IC. An early and accurate assessment of the severity score is essential for the management of severe malaria patients.