[The early warning signs of deterioration of severe acute respiratory syndrome].
OBJECTIVE
To explore the risk factors related to severe cases of severe acute respiratory syndrome (SARS) in order to find the early warning signs of deterioration of this disease.


METHODS
Three hundred and fifty-five patients with severe SARS and 841 patients with regular SARS from Beijing were studied.


RESULTS
Patients with elder age or with comorbid conditions were more likely to develop into severe cases. Data also showed the following characteristics in those severe cases: sustained fever, tachycardia (pulse rate being over 100 per minute), persistent decrease in lymphocytes (< 0.9 x 10(9)/L), increase in neutrophils (> 7.1 x 10(9)/L, 80%), and rapid changes in abnormal chest X-ray. The Cox proportional hazard multi-variable stepwise analysis showed the prediction model of severe SARS included age, comorbid disease, body temperature being still abnormal after 2 days of hospitalization, neutrophil percentage began to increase steadily to more than 80% after 3 days of hospitalization, counts of lymphocytes persisted < 0.9 x 10(9)/L after 4 days of hospitalization.


CONCLUSIONS
According to patient's age, comorbid conditions, one can effectively predict the development of the severe SARS by closely monitoring temperature, pulse rate, the counts of lymphocytes and percent of neutrophils.
Zhao
Min
M
Department of Infectious Diseases, the 302nd Hospital of PLA, Beijing 100039, China.
Fan
Rong
R
Jiang
Tian-jun
TJ
Chen
Zuo
Z
Xie
Gao-qiang
GQ
Xiao
Feng
F
Wu
Yang-feng
YF
Chen
Bo-wen
BW
Han
De-min
DM
D000328:Adult; D000367:Age Factors; D001831:Body Temperature; D042241:Early Diagnosis; D005260:Female; D005334:Fever / Q000175:diagnosis; D006339:Heart Rate; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D012307:Risk Factors; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis*