SrasV1, PascalFrancis, Curation, bibRecord, 000134

Short-term outcome of critically ill patients with severe acute respiratory syndrome

Identifieur interne : 000134 ( PascalFrancis/Curation ); précédent : 000133; suivant : 000135

Short-term outcome of critically ill patients with severe acute respiratory syndrome

Auteurs : Charles D. Gomersall [Hong Kong] ; Gavin M. Joynt [Hong Kong] ; Philip Lam [Hong Kong] ; Thomas Li [Hong Kong] ; Florence Yap [Hong Kong] ; Doris Lam [Hong Kong] ; Thomas A. Buckley [Hong Kong] ; Joseph J. Y. Sung [Hong Kong] ; David S. Hui [Hong Kong] ; Gregory E. Antonio [Hong Kong] ; Anil T. Ahuja [Hong Kong] ; Patricia Leung [Hong Kong]

Source :

Intensive care medicine : (Print) [ 0342-4642 ] ; 2004.

RBID : Pascal:04-0361731

Descripteurs français

Pascal (Inist)
- Infection, Court terme, Pronostic, Pneumonie, Malade état grave, Homme, Coronavirus, Barotraumatisme, Morbidité, Mortalité, Réanimation, Soin intensif, Syndrome respiratoire aigu sévère.
Wicri :
- topic : Homme, Mortalité.

English descriptors

KwdEn :
- Barotrauma, Coronavirus, Critically ill, Human, Infection, Intensive care, Morbidity, Mortality, Pneumonia, Prognosis, Resuscitation, Severe acute respiratory syndrome, Short term.

Abstract

Objective: To document the outcome and determine prognostic factors for patients with severe acute respiratory syndrome who require admission to an intensive care unit. Design: Observational cohort study involving retrospective analysis of demographic, clinical, laboratory and radiological data. Setting: Adult intensive care unit in a tertiary referral university hospital involved in a major outbreak of severe acute respiratory syndrome (SARS). Patients: The first 54 patients admitted with SARS to an intensive care unit (ICU). All were treated with corticosteroids, ribavirin, broad spectrum antimicrobials and supportive therapy. Interventions: None. Measurements and results: All patients were admitted for respiratory failure. The median APACHE II score was 11 (interquartile range 8-13). At 28 days 34 patients (63%; 95% CI 49.6-74.6) were alive and not mechanically ventilated. Six patients were alive but ventilated (11.3%; 95% confidence interval 5.3-22.6) and 14 had died (25.9%; CI 16.1-38.9). Seven of 27 ventilated patients developed evidence of barotrauma (25.9%; 95% CI 13.2-44.7). Median maximal multiple-organ dysfunction score was 5 (interquartile range 3.3-9). Median maximal respiratory dysfunction score was 3 (interquartile range 3-4). Increased age, severity of illness, lymphocyte count, decreased steroid dose, positive fluid balance, chronic disease or immunosuppression and nosocomial sepsis were associated with poor outcome on univariate analysis. Poor outcome was defined as death or need for mechanical ventilation at 28 days after ICU admission. Conclusions: Mortality amongst critically ill patients with SARS is high. It causes predominantly severe respiratory failure, with little other organ failure, and a high incidence of barotrauma amongst those requiring mechanical ventilation.

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A11	`03`	`1`		`@1 LAM (Philip)`
A11	`04`	`1`		`@1 LI (Thomas)`
A11	`05`	`1`		`@1 YAP (Florence)`
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A11	`09`	`1`		`@1 HUI (David S.)`
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A11	`11`	`1`		`@1 AHUJA (Anil T.)`
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A14	`01`			`@1 Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital @2 Shatin @3 HKG @Z 1 aut. @Z 2 aut. @Z 3 aut. @Z 4 aut. @Z 5 aut. @Z 6 aut. @Z 7 aut. @Z 12 aut.`
A14	`02`			`@1 Department of Medicine and Therapeutics The Chinese University of Hong Kong, Prince of Wales Hospital @2 Shatin @3 HKG @Z 8 aut. @Z 9 aut.`
A14	`03`			`@1 Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital @2 Shatin @3 HKG @Z 10 aut. @Z 11 aut.`
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C01	`01`		`ENG`	@0 Objective: To document the outcome and determine prognostic factors for patients with severe acute respiratory syndrome who require admission to an intensive care unit. Design: Observational cohort study involving retrospective analysis of demographic, clinical, laboratory and radiological data. Setting: Adult intensive care unit in a tertiary referral university hospital involved in a major outbreak of severe acute respiratory syndrome (SARS). Patients: The first 54 patients admitted with SARS to an intensive care unit (ICU). All were treated with corticosteroids, ribavirin, broad spectrum antimicrobials and supportive therapy. Interventions: None. Measurements and results: All patients were admitted for respiratory failure. The median APACHE II score was 11 (interquartile range 8-13). At 28 days 34 patients (63%; 95% CI 49.6-74.6) were alive and not mechanically ventilated. Six patients were alive but ventilated (11.3%; 95% confidence interval 5.3-22.6) and 14 had died (25.9%; CI 16.1-38.9). Seven of 27 ventilated patients developed evidence of barotrauma (25.9%; 95% CI 13.2-44.7). Median maximal multiple-organ dysfunction score was 5 (interquartile range 3.3-9). Median maximal respiratory dysfunction score was 3 (interquartile range 3-4). Increased age, severity of illness, lymphocyte count, decreased steroid dose, positive fluid balance, chronic disease or immunosuppression and nosocomial sepsis were associated with poor outcome on univariate analysis. Poor outcome was defined as death or need for mechanical ventilation at 28 days after ICU admission. Conclusions: Mortality amongst critically ill patients with SARS is high. It causes predominantly severe respiratory failure, with little other organ failure, and a high incidence of barotrauma amongst those requiring mechanical ventilation.
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Pascal:04-0361731

Le document en format XML

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<s3>HKG</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>6 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
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<country>Hong Kong</country>
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</author>
<author><name sortKey="Buckley, Thomas A" sort="Buckley, Thomas A" uniqKey="Buckley T" first="Thomas A." last="Buckley">Thomas A. Buckley</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital</s1>
<s2>Shatin</s2>
<s3>HKG</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
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<sZ>7 aut.</sZ>
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<country>Hong Kong</country>
</affiliation>
</author>
<author><name sortKey="Sung, Joseph J Y" sort="Sung, Joseph J Y" uniqKey="Sung J" first="Joseph J. Y." last="Sung">Joseph J. Y. Sung</name>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Medicine and Therapeutics The Chinese University of Hong Kong, Prince of Wales Hospital</s1>
<s2>Shatin</s2>
<s3>HKG</s3>
<sZ>8 aut.</sZ>
<sZ>9 aut.</sZ>
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<country>Hong Kong</country>
</affiliation>
</author>
<author><name sortKey="Hui, David S" sort="Hui, David S" uniqKey="Hui D" first="David S." last="Hui">David S. Hui</name>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Medicine and Therapeutics The Chinese University of Hong Kong, Prince of Wales Hospital</s1>
<s2>Shatin</s2>
<s3>HKG</s3>
<sZ>8 aut.</sZ>
<sZ>9 aut.</sZ>
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<country>Hong Kong</country>
</affiliation>
</author>
<author><name sortKey="Antonio, Gregory E" sort="Antonio, Gregory E" uniqKey="Antonio G" first="Gregory E." last="Antonio">Gregory E. Antonio</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital</s1>
<s2>Shatin</s2>
<s3>HKG</s3>
<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
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<country>Hong Kong</country>
</affiliation>
</author>
<author><name sortKey="Ahuja, Anil T" sort="Ahuja, Anil T" uniqKey="Ahuja A" first="Anil T." last="Ahuja">Anil T. Ahuja</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital</s1>
<s2>Shatin</s2>
<s3>HKG</s3>
<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Hong Kong</country>
</affiliation>
</author>
<author><name sortKey="Leung, Patricia" sort="Leung, Patricia" uniqKey="Leung P" first="Patricia" last="Leung">Patricia Leung</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital</s1>
<s2>Shatin</s2>
<s3>HKG</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>6 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Hong Kong</country>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Intensive care medicine : (Print)</title>
<title level="j" type="abbreviated">Intensive care med. : (Print)</title>
<idno type="ISSN">0342-4642</idno>
<imprint><date when="2004">2004</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Intensive care medicine : (Print)</title>
<title level="j" type="abbreviated">Intensive care med. : (Print)</title>
<idno type="ISSN">0342-4642</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Barotrauma</term>
<term>Coronavirus</term>
<term>Critically ill</term>
<term>Human</term>
<term>Infection</term>
<term>Intensive care</term>
<term>Morbidity</term>
<term>Mortality</term>
<term>Pneumonia</term>
<term>Prognosis</term>
<term>Resuscitation</term>
<term>Severe acute respiratory syndrome</term>
<term>Short term</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Infection</term>
<term>Court terme</term>
<term>Pronostic</term>
<term>Pneumonie</term>
<term>Malade état grave</term>
<term>Homme</term>
<term>Coronavirus</term>
<term>Barotraumatisme</term>
<term>Morbidité</term>
<term>Mortalité</term>
<term>Réanimation</term>
<term>Soin intensif</term>
<term>Syndrome respiratoire aigu sévère</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
<term>Mortalité</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Objective: To document the outcome and determine prognostic factors for patients with severe acute respiratory syndrome who require admission to an intensive care unit. Design: Observational cohort study involving retrospective analysis of demographic, clinical, laboratory and radiological data. Setting: Adult intensive care unit in a tertiary referral university hospital involved in a major outbreak of severe acute respiratory syndrome (SARS). Patients: The first 54 patients admitted with SARS to an intensive care unit (ICU). All were treated with corticosteroids, ribavirin, broad spectrum antimicrobials and supportive therapy. Interventions: None. Measurements and results: All patients were admitted for respiratory failure. The median APACHE II score was 11 (interquartile range 8-13). At 28 days 34 patients (63%; 95% CI 49.6-74.6) were alive and not mechanically ventilated. Six patients were alive but ventilated (11.3%; 95% confidence interval 5.3-22.6) and 14 had died (25.9%; CI 16.1-38.9). Seven of 27 ventilated patients developed evidence of barotrauma (25.9%; 95% CI 13.2-44.7). Median maximal multiple-organ dysfunction score was 5 (interquartile range 3.3-9). Median maximal respiratory dysfunction score was 3 (interquartile range 3-4). Increased age, severity of illness, lymphocyte count, decreased steroid dose, positive fluid balance, chronic disease or immunosuppression and nosocomial sepsis were associated with poor outcome on univariate analysis. Poor outcome was defined as death or need for mechanical ventilation at 28 days after ICU admission. Conclusions: Mortality amongst critically ill patients with SARS is high. It causes predominantly severe respiratory failure, with little other organ failure, and a high incidence of barotrauma amongst those requiring mechanical ventilation.</div>
</front>
</TEI>
<inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0342-4642</s0>
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</fA05>
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<fA08 i1="01" i2="1" l="ENG"><s1>Short-term outcome of critically ill patients with severe acute respiratory syndrome</s1>
</fA08>
<fA11 i1="01" i2="1"><s1>GOMERSALL (Charles D.)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>JOYNT (Gavin M.)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>LAM (Philip)</s1>
</fA11>
<fA11 i1="04" i2="1"><s1>LI (Thomas)</s1>
</fA11>
<fA11 i1="05" i2="1"><s1>YAP (Florence)</s1>
</fA11>
<fA11 i1="06" i2="1"><s1>LAM (Doris)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>BUCKLEY (Thomas A.)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>SUNG (Joseph J. Y.)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>HUI (David S.)</s1>
</fA11>
<fA11 i1="10" i2="1"><s1>ANTONIO (Gregory E.)</s1>
</fA11>
<fA11 i1="11" i2="1"><s1>AHUJA (Anil T.)</s1>
</fA11>
<fA11 i1="12" i2="1"><s1>LEUNG (Patricia)</s1>
</fA11>
<fA14 i1="01"><s1>Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital</s1>
<s2>Shatin</s2>
<s3>HKG</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>6 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Department of Medicine and Therapeutics The Chinese University of Hong Kong, Prince of Wales Hospital</s1>
<s2>Shatin</s2>
<s3>HKG</s3>
<sZ>8 aut.</sZ>
<sZ>9 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital</s1>
<s2>Shatin</s2>
<s3>HKG</s3>
<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
</fA14>
<fA20><s1>381-387</s1>
</fA20>
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</fA21>
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</fA23>
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<s5>354000116908160050</s5>
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<s1>© 2004 INIST-CNRS. All rights reserved.</s1>
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<fA45><s0>22 ref.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>04-0361731</s0>
</fA47>
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<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>Intensive care medicine : (Print)</s0>
</fA64>
<fA66 i1="01"><s0>DEU</s0>
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<fC01 i1="01" l="ENG"><s0>Objective: To document the outcome and determine prognostic factors for patients with severe acute respiratory syndrome who require admission to an intensive care unit. Design: Observational cohort study involving retrospective analysis of demographic, clinical, laboratory and radiological data. Setting: Adult intensive care unit in a tertiary referral university hospital involved in a major outbreak of severe acute respiratory syndrome (SARS). Patients: The first 54 patients admitted with SARS to an intensive care unit (ICU). All were treated with corticosteroids, ribavirin, broad spectrum antimicrobials and supportive therapy. Interventions: None. Measurements and results: All patients were admitted for respiratory failure. The median APACHE II score was 11 (interquartile range 8-13). At 28 days 34 patients (63%; 95% CI 49.6-74.6) were alive and not mechanically ventilated. Six patients were alive but ventilated (11.3%; 95% confidence interval 5.3-22.6) and 14 had died (25.9%; CI 16.1-38.9). Seven of 27 ventilated patients developed evidence of barotrauma (25.9%; 95% CI 13.2-44.7). Median maximal multiple-organ dysfunction score was 5 (interquartile range 3.3-9). Median maximal respiratory dysfunction score was 3 (interquartile range 3-4). Increased age, severity of illness, lymphocyte count, decreased steroid dose, positive fluid balance, chronic disease or immunosuppression and nosocomial sepsis were associated with poor outcome on univariate analysis. Poor outcome was defined as death or need for mechanical ventilation at 28 days after ICU admission. Conclusions: Mortality amongst critically ill patients with SARS is high. It causes predominantly severe respiratory failure, with little other organ failure, and a high incidence of barotrauma amongst those requiring mechanical ventilation.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B27B</s0>
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<fC03 i1="01" i2="X" l="FRE"><s0>Infection</s0>
<s2>NM</s2>
<s5>01</s5>
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<fC03 i1="01" i2="X" l="ENG"><s0>Infection</s0>
<s2>NM</s2>
<s5>01</s5>
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<s2>NM</s2>
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<s5>02</s5>
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<s5>03</s5>
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<s5>06</s5>
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<s5>06</s5>
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<fC03 i1="06" i2="X" l="SPA"><s0>Hombre</s0>
<s5>06</s5>
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<s2>NW</s2>
<s5>08</s5>
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<fC03 i1="07" i2="X" l="ENG"><s0>Coronavirus</s0>
<s2>NW</s2>
<s5>08</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Coronavirus</s0>
<s2>NW</s2>
<s5>08</s5>
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<fC03 i1="08" i2="X" l="FRE"><s0>Barotraumatisme</s0>
<s5>09</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Barotrauma</s0>
<s5>09</s5>
</fC03>
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<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Morbidité</s0>
<s5>11</s5>
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<s5>11</s5>
</fC03>
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<s5>11</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE"><s0>Mortalité</s0>
<s5>12</s5>
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<s5>12</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA"><s0>Mortalidad</s0>
<s5>12</s5>
</fC03>
<fC03 i1="11" i2="X" l="FRE"><s0>Réanimation</s0>
<s5>14</s5>
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<fC03 i1="11" i2="X" l="ENG"><s0>Resuscitation</s0>
<s5>14</s5>
</fC03>
<fC03 i1="11" i2="X" l="SPA"><s0>Reanimación</s0>
<s5>14</s5>
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<fC03 i1="12" i2="X" l="FRE"><s0>Soin intensif</s0>
<s5>15</s5>
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<s5>15</s5>
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<s5>15</s5>
</fC03>
<fC03 i1="13" i2="X" l="FRE"><s0>Syndrome respiratoire aigu sévère</s0>
<s4>CD</s4>
<s5>96</s5>
</fC03>
<fC03 i1="13" i2="X" l="ENG"><s0>Severe acute respiratory syndrome</s0>
<s4>CD</s4>
<s5>96</s5>
</fC03>
<fC03 i1="13" i2="X" l="SPA"><s0>Síndrome respiratorio agudo severo</s0>
<s4>CD</s4>
<s5>96</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Coronaviridae</s0>
<s2>NW</s2>
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<fC07 i1="01" i2="X" l="ENG"><s0>Coronaviridae</s0>
<s2>NW</s2>
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<fC07 i1="01" i2="X" l="SPA"><s0>Coronaviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Nidovirales</s0>
<s2>NW</s2>
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<s2>NW</s2>
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<fC07 i1="02" i2="X" l="SPA"><s0>Nidovirales</s0>
<s2>NW</s2>
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<fC07 i1="03" i2="X" l="FRE"><s0>Virus</s0>
<s2>NW</s2>
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<s2>NW</s2>
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<fC07 i1="03" i2="X" l="SPA"><s0>Virus</s0>
<s2>NW</s2>
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<s5>37</s5>
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<s5>37</s5>
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<s5>37</s5>
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<s5>38</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Lung disease</s0>
<s5>38</s5>
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<s5>38</s5>
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<s2>NM</s2>
<s5>39</s5>
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<s2>NM</s2>
<s5>39</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA"><s0>Virosis</s0>
<s2>NM</s2>
<s5>39</s5>
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<fC07 i1="07" i2="X" l="FRE"><s0>Traumatisme</s0>
<s5>40</s5>
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<fC07 i1="07" i2="X" l="ENG"><s0>Trauma</s0>
<s5>40</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA"><s0>Traumatismo</s0>
<s5>40</s5>
</fC07>
<fN21><s1>208</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
</standard>
</inist>
</record>

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Short-term outcome of critically ill patients with severe acute respiratory syndrome

Short-term outcome of critically ill patients with severe acute respiratory syndrome

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