title: Clinical characteristics of fatal patients with severe acute respiratory syndrome in a medical center in Taipei.
abstract: BACKGROUND
  The clinical spectrum of severe acute respiratory syndrome (SARS) varies widely in the way that asymptomatic carriers are believed to exist in the community. Still there are severe forms of illness in which the patients deteriorate unexpectedly within hours. This study delineates clinical characteristics of such fatal cases of SARS for the purpose of identifying patients with poor outcome.
  
  
  METHODS
  Patients with the diagnosis of probable or suspected SARS admitted to the Taipei Veterans General Hospital during the period from March 26, 2003 to May 25, 2003 were included. The medical records of fatal cases were retrospectively reviewed.
  
  
  RESULTS
  During the study period, thirty-six probable cases and 17 suspected cases of SARS were identified. Eight probable but none of the suspected cases died from acute respiratory distress syndrome (ARDS) with multiple organ dysfunction after a median of 6-day hospital stay (range, 1-30 days). All but 2 patients acquired the infection nosocomially. Of the fatal cases, four were males and 4 females, with the median age of 65 years (range, 29-76 yrs). All except 3 had co-morbid conditions, such as hypertension, diabetes mellitus, coronary artery disease or chronic obstructive pulmonary disease. The lactate dehydrogenase (LDH) values were abnormal (> 200 U/L) in all patients. The chest radiograph of these fatal cases consistently showed multifocal infiltration over the unilateral or bilateral lobe of the lung.
  
  
  CONCLUSIONS
  Patients of SARS who had advanced age, co-morbid conditions, highly elevated LDH and multifocal infiltration over chest radiograph should be closely monitored and actively treated.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Taipei Veteran General Hospital, Taipei, Taiwan, ROC. wwwong@vghtpe.gov.tw
authors.forename: Wing-Wai
authors.initials: WW
authors.lastname: Wong
authors.forename: Te-Li
authors.initials: TL
authors.lastname: Chen
authors.forename: Su-Pen
authors.initials: SP
authors.lastname: Yang
authors.forename: Fu-Der
authors.initials: FD
authors.lastname: Wang
authors.forename: Nai-Cheng
authors.initials: NC
authors.lastname: Cheng
authors.forename: Benjamin Ing-Tiau
authors.initials: BI
authors.lastname: Kuo
authors.forename: Kwok-Woon
authors.initials: KW
authors.lastname: Yu
authors.forename: Che-An
authors.initials: CA
authors.lastname: Tsai
authors.forename: Yu-Shia
authors.initials: YS
authors.lastname: Lin
authors.forename: I-Ru
authors.initials: IR
authors.lastname: Lee
authors.forename: Chih-Yu
authors.initials: CY
authors.lastname: Chi
authors.forename: Chorng-Jang
authors.initials: CJ
authors.lastname: Lai
authors.forename: Chung-Hsu
authors.initials: CH
authors.lastname: Lai
authors.forename: Hsin-Pai
authors.initials: HP
authors.lastname: Chen
authors.forename: Cheng-Yi
authors.initials: CY
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis / Q000401:mortality* / Q000635:transmission; D013624:Taiwan
chemical_list: D007770:L-Lactate Dehydrogenase