Predicting Mortality in Patients with Tuberculous Destroyed Lung Receiving Mechanical Ventilation

Area of Science:

• Pulmonology
• Critical Care Medicine
• Infectious Diseases

Background:

• Tuberculous destroyed lung (TDL) patients requiring mechanical ventilation have a high mortality rate.
• Developing accurate prognostic models is crucial for managing these critically ill patients.

Purpose of the Study:

• To develop and validate a mortality prediction model for TDL patients on mechanical ventilation.
• To identify clinical factors associated with intensive care unit (ICU) mortality in TDL patients.

Main Methods:

• Retrospective review of 125 TDL patients who received mechanical ventilation.
• Binary logistic regression analysis to identify mortality predictors.
• Development of the TDL-Vent score based on significant variables and a modified score including brain natriuretic peptide.

Main Results:

• The TDL-Vent score incorporated age ≥65 years, vasopressor use, and low PaO2/FiO2 ratio (<180).
• The TDL-Vent and modified TDL-Vent scores demonstrated significant correlations with 60-day mortality (p<0.001 and p=0.001, respectively).
• Both developed scores showed superior predictive performance compared to other illness severity scores.

Conclusions:

• The TDL-Vent model effectively identifies TDL patients on mechanical ventilation at high risk of mortality.
• Further prospective validation in larger cohorts is recommended to confirm the model's utility.