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Prognostic factors in pulmonary tuberculosis requiring mechanical ventilation for acute respiratory failure

Yon Ju Ryu1, Won-Jung Koh, Eun Hae Kang

  • 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Respirology (Carlton, Vic.)
|June 2, 2007
PubMed
Abstract

Insights

Pulmonary tuberculosis causing acute respiratory failure and requiring mechanical ventilation has a high mortality rate. Tuberculous-destroyed lungs, high APACHE II scores, and sepsis predict in-hospital death.

Area of Science:

  • Pulmonology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Pulmonary tuberculosis (TB) is a significant cause of respiratory illness.
  • Acute respiratory failure (ARF) in TB patients necessitates mechanical ventilation, often with a poor prognosis.
  • Identifying mortality predictors is crucial for managing these complex cases.

Purpose of the Study:

  • To determine factors associated with in-hospital mortality in patients with pulmonary TB and ARF requiring mechanical ventilation.

Main Methods:

  • Retrospective review of medical records for 32 patients with active pulmonary TB causing ARF.
  • Analysis of data from a tertiary referral hospital's medical intensive care unit (ICU) over a 10-year period.
  • Assessment of predictors for in-hospital mortality.

Main Results:

  • Overall in-hospital mortality was 59% (19/32 patients).
  • Independent predictors of mortality included tuberculous-destroyed lungs (HR 6.61), Acute Physiology and Chronic Health Evaluation II (APACHE II) scores ≥20 (HR 4.90), and sepsis (HR 5.84).
  • Median age was 69 years, with median ICU stay of 11 days and mechanical ventilation of 9 days.

Conclusions:

  • ARF due to pulmonary TB requiring mechanical ventilation carries a high mortality rate.
  • Tuberculous-destroyed lungs, elevated APACHE II scores, and sepsis are significant independent predictors of mortality.
  • These findings highlight the need for vigilant management and early intervention in high-risk TB patients.

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