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Outcomes and Prognostic Factors in 267 Patients with Severe Acute Respiratory Syndrome in Hong Kong.
- Source :
-
Annals of Internal Medicine . 11/4/2003, Vol. 139 Issue 9, p715-723. 9p. 5 Charts, 2 Graphs. - Publication Year :
- 2003
-
Abstract
- Background: Severe acute respiratory syndrome (SARS) has become a global public health emergency. Objective: To evaluate the characteristics and outcomes of patients with SARS in Hong Kong and to identify predictors of mortality. Design: Retrospective cohort study. Setting: Quarantine hospital for patients with SARS in Hong Kong. Patients: 267 consecutive patients hospitalized from 26 February to 31 March 2003 for probable or confirmed SARS. Measurements: Clinical, laboratory, and radiographic measures; 3-month mortality rate. Results: According to our case definition, there were 227 cases of confirmed SARS and 40 cases of probable SARS. Common presenting symptoms were fever (99% of patients), chills (74%), malaise (63%), and myalgia (50%). Laboratory findings included lymphopenia (73%), thrombocytopenia (50%), hyponatremia (60%), and elevated levels of lactate dehydrogenase (47%) and C-reactive protein (75%). During hospitalization, incidence of diarrhea (53%), anemia (53%), and acute renal failure (6%) increased. Sixty-nine patients (26%) required intensive care because of respiratory failure. The 3-month mortality rate was 12% (95% CI, 8% to 16%). Factors contributing to mortality were respiratory failure, acute renal failure, and nosocomial sepsis. On multivariate Cox regression, age older than 60 years (relative risk, 5.10 [CI, 2.30 to 11.31]; P < 0.001) and lactate dehydrogenase level greater than 3.8 μkat/L at presentation (relative risk, 2.20 [CI, 1.03 to 4.71]; P = 0.04) were independent predictors of mortality. Conclusion: Because of the longer follow-up period in our cohort, the mortality rate in these patients is higher than rates reported in previous studies. Advanced age and high lactate dehydrogenase level at presentation predict mortality. [ABSTRACT FROM AUTHOR]
- Subjects :
- *SARS disease
*PUBLIC health
Subjects
Details
- Language :
- English
- ISSN :
- 00034819
- Volume :
- 139
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Annals of Internal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 11264469