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ORIGINAL RESEARCH ARTICLES |
Factors Affecting Mortality In Diffuse Alveolar Hemorrhage Syndromes
Dr. Alev GÜRGÜNa, Dr. Pelin KÖŞKERa, Dr. Alev SUSURa, Dr. M. Sezai TAŞBAKANa, Dr. Özen K. BAŞOĞLUa, Dr. Ali VERALb, Dr. Feza BACAKOĞLUa
aGöğüs Hastalıkları AD, bPatoloji AD, Ege Üniversitesi Tıp Fakültesi, İzmir
Aim: Diffuse alveolar hemorrhage syndromes (DAHS) are a group of disease caused by immune and nonimmune disorders with a high morbidity and mortality. Therefore the factors affecting mortality in patients with DAHS are aimed to be evaluated retrospectively in this study. Material and Methods: Totally 24 DAHS cases (12 male, mean age 57.1 ± 18.9 yrs) diagnosed between 1998 and 2007 in our clinic were evaluated according to the patient data. Results: The diagnoses of the patients were ARDS due to DAHS (62.5%), community acquired pneumonia (20.8%) and pulmonary involvement of connective tissue disorders (16.7%). Nine patients had connective tissue disorder (mean disease duration 47.7 ± 54.7 months), 11 patients were on corticosteroid therapy and 5 patients had a history of cytostatic therapy. Only 10 patients (41.7%) had hemoptysis on admission. Hypoxemic respiratory failure was found in 70.8% of the patients and 58.3% of them required invasive mechanical ventilation. Sixteen cases received ”pulse” corticosteroid therapy and 13 cases had blood transfusion. During the follow-up, 15 patients (62.5%) developed nosocomial pneumonia and 13 patients (54.2%) died. The patients with a baseline haemoglobin level of 10 gr/dl or less, had higher levels of CRP (20.7 ± 18.0 vs. 11.3 ± 8.0 mg/dl, p= 0.024). The patients died during the follow-up, had shorter duration of symptoms (13.6 ± 15.2 vs. 54.7 ± 81.7 days, p= 0.001) and higher baseline CRP levels (20.6 ± 14.5 vs. 8.6 ± 6.5 mg/dl, p= 0.020). Conclusion: The mortality rate was high in DAHS patients and the baseline CRP level is thought to be important for predicting mortality.Keywords: Alveolar process, hemorrhage, mortalityTurkiye Klinikleri Arch Lung 2009;10(2):39-44
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