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Comparative Study
. 2006 May;35(5):326-31.

SARS in Singapore--predictors of disease severity

Hoe-Nam Leong  1 , Arul Earnest, Hong-Huay Lim, Chee-Fang Chin, Colin S H Tan, Mark E Puhaindran, Alex C H Tan, Mark I C Chen, Yee-Sin Leo
Affiliations
  • PMID: 16829999
Free article
Comparative Study

SARS in Singapore--predictors of disease severity

Hoe-Nam Leong et al. Ann Acad Med Singap. 2006 May.
Free article

Abstract

Introduction: Severe acute respiratory syndrome (SARS) affected 8096 individuals in 29 countries, with 774 deaths. In Singapore, there were 238 cases of SARS with 33 deaths. A retrospective analysis was performed to identify predictors of poor outcome in patients with SARS locally.

Materials and methods: Clinical, laboratory and outcome data of 234 patients admitted to Tan Tock Seng Hospital and Singapore General Hospital were collected and analysed. Only data collected at the time of admission were used in the analysis for predictors of poor outcome. Adverse events were defined as admission to the intensive care unit or death.

Results: Clinical (temperature, FiO2) and laboratory [leukocyte, lymphocyte, neutrophil, platelet, lactate dehydrogenase (LDH), albumin] trends in groups with and without an adversarial event were presented. Fifty patients experienced an adverse event. On univariate analysis, male gender, advanced age, presence of comorbidities, neutrophilia, lymphopaenia, hyponatraemia, hypoalbuminaemia, transaminitis and elevated LDH or C-reactive protein were found to be significant predictors. On multivariate analysis, predictors of poor outcome were increased age [odds ratio (OR) 1.73 for every 10-year increase; 95% CI, 1.35 to 2.21], neutrophilia (OR 1.06 for every 1 x 10(9)/L increase; 95% CI, 1.02 to 1.11) and high LDH (OR 1.17 for every 100 U/L increase; 95% CI, 1.02 to 1.34). None of the 12 paediatric patients had an adverse event.

Conclusion: Advanced age, neutrophilia and high LDH predict poor outcomes in patients with SARS.

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