title: A cluster of patients with severe acute respiratory syndrome in a chest ward in southern Taiwan.
abstract: OBJECTIVE
  Severe acute respiratory syndrome (SARS) is an emerging and easily clustering infectious disease. We describe an outbreak of SARS in a chest ward of a medical center in southern Taiwan and seek to identify the risk factors of those SARS patients who required mechanical ventilation. We focus on previous health patients.
  
  
  METHODS
  This retrospective case series was collected during the SARS outbreak. Degrees of severity were established, based on whether intubation and mechanical ventilation was necessary.
  
  
  METHODS
  A 2500-bed medical center in southern Taiwan.
  
  
  METHODS
  Forty-four patients exhibited symptoms that met the modified World Health Organization (WHO) definition of SARS. These included of three subgroups: health-care workers ( n=16), relatives ( n=14), and patients already admitted for other ailments ( n=14). Of these, 20 eventually required mechanical ventilation.
  
  
  RESULTS
  Laboratory analyses showed statistically significant differences between intubated and nonintubated patients in white blood cell count, neutrophil percentage, and C-reactive protein level as well as in age and underlying malignancy. Risk factors for SARS patients who had been healthy prior to their illness included old age, high peak fever grade, increased neutrophil count, increased neutrophil percentage, and close or prolonged contact with a SARS patient.
  
  
  CONCLUSIONS
  Old age, high white blood cell counts, high peak grade fever, and close or prolonged contact with a SARS patient increase the risk of intubation in previous healthy SARS patients.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chang Gung Memorial Hospital, Kaohsiung, Chang Gung University, 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien, 833 Taipei, Taiwan.
authors.forename: Yi-Hsi
authors.initials: YH
authors.lastname: Wang
authors.forename: An-Shen
authors.initials: AS
authors.lastname: Lin
authors.forename: Tung-Ying
authors.initials: TY
authors.lastname: Chao
authors.forename: Sheng-Nan
authors.initials: SN
authors.lastname: Lu
authors.forename: Jien-Wei
authors.initials: JW
authors.lastname: Liu
authors.forename: Shun-Sheng
authors.initials: SS
authors.lastname: Chen
authors.forename: Meng-Chih
authors.initials: MC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004196:Disease Outbreaks / Q000517:prevention & control*; D005260:Female; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control / Q000706:statistics & numerical data; D007442:Intubation, Intratracheal; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012124:Respiratory Care Units; D012131:Respiratory Insufficiency / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D013624:Taiwan / Q000453:epidemiology