[Analysis and causation discussion of 185 severe acute respiratory syndrome dead cases].

Li, Chun-sheng; Pan, Shi-fen

OBJECTIVE To proceed the retrospective analysis of the dead reasons of patients with severe acute respiratory syndrome (SARS), in order to provide experience for decreasing mortality of SARS patients in clinic. METHODS Retrospective analyze of 185 dead cases of SARS patients, including age, basic diseases, laboratory tests, radiological test and therapy. RESULTS There were 102 men and 83 women in 185 dead cases of SARS, in which average age was 56.4 years, 85 cases were older than 60 years. 147 cases (79.5%) had basic diseases, cardiovascular disease (57 cases) was at the first Place; diabetes mellitus (41 cases) was at the second Place; cerebrovascular disease (19 cases) was at the third place; 15 patients had alimentary disease. 52 patients (28.1%) suffered from complications, which were acute respiratory distress syndrome (ARDS), secondary infection and multiple organ dysfunctional syndrome (MODS) by order. Some of the patients having complete information showed that life symptoms were stabilization. Hemogram and blood gas analysis showed that blood sugar and white blood cell (WBC) increased (P<0.001); lymphocyte decreased significantly (P<0.005) and PaO(2), PaO(2)/FiO(2) decreased Progressively (P<0.005 P<0.001) in late stage of SARS versus just entering the hospital. Half patients showed the abnormality of biochemical indexes. CONCLUSION Age and basic diseases are sensitive indexes for predicting dead tendency of SARS. Lung injury, obstinate hypoxemia, abnormality metabolize of hyperglycemia and misusing glucocorticoids and antibiotic leading to secondary infection are the main reasons for SARS patients dying.