Korean Journal of Nephrology 1993;12(3):280-285.

신증후성출혈열의 사인 분석

이정상 , 한진석 , 김연수 , 허우성 , 윤형진 , 안규리 , 김성권

Abstract

Recently the case mortality and the causes of death of HFRS would be changed with the improvement of diagnostic methods and therapeutic modalities. The increased incidences of the lesser severe cases by Seoul virus infection would be another factor to this change. There are only few reports about case mortality and causes of death in the cilivilian patients. To know the changes of these problems, we analyzed 16 fatalities at the Seoul National University Hospital among the 228 patients with HFRS from January 1985 to December 1992. The case mortality was 7%, and it increased with the age. The causes of death were primary shock(4), respira- tory failure(5), cerebrovascular accident(CVA)(2) and sepsis(5). The fatalities were 4 in the hypotensive, 5 in the oliguric, 6 in the diuretic and 1 in the convalescent phase. The causes of death in each phase were primary shock in the hypotensive, respiratory failure and CVA in the oliguric, respiratory failure and sepsis in the diuretic and convalescent phases. Deaths with primary shock were all within the first week of the illness. The deaths within the second week were caused by CVA, respira- tory failure and sepsis. After the second week sepsis was the cause of all deaths. The death occurred over 7 days after the admission were 3, and all due to sepsis. Conclusion: The case mortality was not decreased in the civilian patients with HFRS, The major causes of death were respiratory failure, sepsis, primary shock, and CVA. All deaths due to primary shock occurred in the hypotensive phase, and sepsis was the only cause of death after the diuretic phase.