Document Detail


Value of initial chest radiographs for predicting clinical outcomes in patients with severe acute respiratory syndrome.
MedLine Citation:
PMID:  15308434     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine whether the initial chest radiograph is helpful in predicting the clinical outcome of patients with severe acute respiratory syndrome (SARS). METHODS: Of 343 patients who met the World Health Organization's case definition of probable SARS and who had been admitted to a regional hospital in Hong Kong, 201 patients had laboratory evidence of SARS coronavirus infection. The initial frontal chest radiographs of these 201 patients were assessed in a blinded fashion by 3 radiologists; individual findings were accepted if at least 2 of the radiologists concurred. Independent predictors of an adverse outcome, defined as the need for assisted ventilation, death, or both, were identified by multivariate analysis. RESULTS: Bilateral disease and involvement of more than two zones on the initial chest radiograph were associated with a higher risk of liver impairment and poor clinical outcome. Forty-two patients (21%) developed an adverse outcome. Multivariate analysis showed that lung involvement of more than two zones (odds ratio [OR] = 7.0; 95% confidence interval [CI]: 2.7 to 17.9), older age (OR for each decade of life = 1.5; 95% CI: 1.1 to 2.0), and shortness of breath on admission (OR = 2.8; 95% CI: 1.1 to 7.4) were independent predictors of an adverse outcome. CONCLUSION: Frontal chest radiographs on presentation may have prognostic value in patients with SARS.
Authors:
Tai-Nin Chau; Po-Oi Lee; Kin-Wing Choi; Chiu-Man Lee; Ka-Fai Ma; Tak-Yin Tsang; Yuk-Keung Tso; Ming-Chee Chiu; Wing-Lok Tong; Wai-Cho Yu; Sik-To Lai
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The American journal of medicine     Volume:  117     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-08-13     Completed Date:  2004-09-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  249-54     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine and Geriatrics, Princess Margaret Hospital, Lai Chi Kok, Hong Kong Special Administrative Region. chautainin@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Alanine Transaminase / metabolism
Biological Markers / blood
Female
Hong Kong / epidemiology
Humans
Lung / pathology,  radiography,  virology
Male
Middle Aged
Multivariate Analysis
Observer Variation
Patient Admission
Predictive Value of Tests
ROC Curve
Radiographic Image Enhancement
Radiography, Thoracic* / standards*
Respiration, Artificial
Retrospective Studies
Reverse Transcriptase Polymerase Chain Reaction
Risk Factors
SARS Virus
Serologic Tests
Severe Acute Respiratory Syndrome / diagnosis*,  epidemiology,  therapy
Statistics as Topic
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; EC 2.6.1.2/Alanine Transaminase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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