Clinical Features and Outcomes of Severe Acute Respiratory Syndrome and Predictive Factors for Acute Respiratory Distress Syndrome
| Autor: | Cheng-Yu Chen, Lee-Min Wang, Reury-Perng Perng, Chen-Hsen Lee, Cheng-Yi Liu, Jia-Horng Wang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty ARDS Taiwan severe acute respiratory syndrome World Health Organization Article Diagnosis Differential Risk Factors Diabetes mellitus Internal medicine medicine pneumonia Humans Leukocytosis Intensive care medicine Aged Retrospective Studies Aged 80 and over Medicine(all) Inpatients lcsh:R5-920 Clinical Trials as Topic Respiratory Distress Syndrome business.industry Mortality rate Retrospective cohort study General Medicine Odds ratio Middle Aged acute respiratory distress syndrome medicine.disease Prognosis Confidence interval Hospitals Pneumonia Female medicine.symptom business lcsh:Medicine (General) |
| Zdroj: | Journal of the Chinese Medical Association Journal of the Chinese Medical Association, Vol 68, Iss 1, Pp 4-10 (2005) |
| ISSN: | 1728-7731 1726-4901 |
| Popis: | Background: Severe acute respiratory syndrome (SARS) is an emerging infectious disease, and indeed, the SARS epidemic in Taiwan from March to July 2003 had a great impact. This study depicts the clinical characteristics and short-term outcomes of patients with SARS treated at Taipei Veterans General Hospital; potential predictive factors for acute respiratory distress syndrome (ARDS) are also analyzed. Methods: This study retrospectively analyzed data for 67 SARS patients, who were grouped according to whether or not ARDS developed during the clinical course of SARS. Results: There were 32 males (mean age, 50.3 years; range, 20‐75 years) and 35 females (mean age, 51.1 years; range, 23‐86 years). Twenty-five patients (37.3%) were health care workers. At admission, 50 patients (74.6%) had abnormal chest radiographs, and all patients developed pulmonary infiltrates during the following week. During hospitalization, lymphopenia was found in 57 patients (85.1%); and elevated levels of lactate dehydrogenase (LDH; n = 55; 83.3%), C-reactive protein (n = 55; 83.3%), aminotransferases (n = 44; 65.7%), and creatine kinase (n = 14; 20.9%) were also noted. ARDS developed in 33 patients (49.3%), who were generally older than the patients in whom ARDS did not develop, male, non-health care workers, and who generally had dyspnea at the time of diagnosis, and a history of diabetes mellitus, hypertension or cerebrovascular accident. Patients with, versus those without, ARDS also tended to present with more severe lymphopenia and leukocytosis, and with higher levels of LDH and aspartate aminotransferase. The overall mortality rate was 31.3% (21/67), whereas the rate for patients who developed ARDS was 63.6% (21/33). Multivariate analyses showed that age greater than 65 years (odds ratio, OR, 10.6; 95% confidence interval, CI, 2.1‐54.1), pre-existing diabetes mellitus (OR, 13.7; 95% CI, 1.3‐146.9), and elevated levels of LDH (OR, 8.4; 95% CI, 1.9‐36.9) at admission, were independent predictors of ARDS. Conclusion: The clinical manifestations of SARS showed high variability, and were related to the underlying health status of individual patients. Importantly, the development of ARDS was associated with significant mortality, despite aggressive therapy. [J Chin Med Assoc 2005;68(1):4‐10] |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|