Hematological and biochemical factors predicting SARS fatality in Taiwan.
OBJECTIVE
Severe acute respiratory syndrome (SARS) has a high fatality rate worldwide. We examined the epidemiologic and clinical factors associated with death for all laboratory-confirmed SARS patients in Taiwan.


METHODS
Using initial data in medical records reported by hospitals to the Center for Disease Control in Taiwan, we analyzed whether hematological, biochemical and arterial blood gas measures could predict fatality in 346 SARS patients.


RESULTS
Both fatalities (n = 73; 21.1%) and survivors had elevated plasma concentration of initial C-reactive protein (CRP), but the mean CRP concentration was higher in fatalities (47.7 +/- 43.3 mg/L) than in survivors (24.6 +/- 28.2 mg/L). Initial lymphocyte counts were low in both fatalities (814 +/- 378/microL) and survivors (1019 +/- 480/microL). After controlling for age and sex, multiple logistic regression analysis showed that hematological factors significantly associated with fatality included initial neutrophil count > 7000/microL (odds ratio [OR] = 6.4), initial CRP concentration > 47.5 mg/L (OR = 5.8) and lactic acid dehydrogenase (LDH) > 593.5 IU/L (OR = 4.2). Factors significantly associated with initial CRP concentration > 47.5 mg/L included dyspnea (OR = 4.3), red blood cell count < 4.1 x 106/microL (OR = 4.3) and serum aspartate aminotransferase > 57 IU/L (OR = 3.1).


CONCLUSIONS
Initial neutrophil count, CRP and LDH levels are important predictors of mortality from SARS.
Chang
Hsiao-Ling
HL
The Center for Disease Control, Department of Health, Taiwan.
Chen
Kow-Tong
KT
Lai
Shu-Kuan
SK
Kuo
Hung-Wei
HW
Su
Ih-Jen
IJ
Lin
Ruey S
RS
Sung
Fung-Chang
FC
D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D045169:Severe Acute Respiratory Syndrome / Q000097:blood* / Q000401:mortality*; D013624:Taiwan / Q000453:epidemiology
D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase