Risk factors for death in tuberculosis patients requiring ICU care

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Pulmonology

Background:

• Prognostic factors for in-hospital mortality in tuberculosis (TB) patients requiring intensive care unit (ICU) admission are not well-defined.
• Tuberculosis remains a significant global health challenge, particularly in high-burden settings.

Purpose of the Study:

• To estimate the in-hospital mortality rate among TB patients admitted to the ICU.
• To identify significant risk factors associated with in-hospital mortality in this patient population.

Main Methods:

• A retrospective study was conducted on culture-confirmed TB patients admitted to the ICU between March 2012 and April 2019.
• Data including demographics, comorbidities, and laboratory measures were collected from medical records.
• Cox proportional hazards regression model was employed to determine prognostic factors for in-hospital mortality.

Main Results:

• A total of 82 TB patients requiring ICU care were analyzed, with an in-hospital mortality rate of 26.8% (22 deaths).
• Low serum albumin levels (HR: 0.8 per 1 g/l) and high white blood cell (WBC) counts (HR: 1.1 per 1 × 10^9/l) were significantly associated with increased mortality.
• These associations remained significant after adjusting for sex and age in the multivariable model.

Conclusions:

• In-hospital mortality for TB patients admitted to the ICU remains high.
• Serum albumin and WBC count are critical prognostic indicators for mortality in critically ill TB patients.
• These findings highlight the need for close monitoring of these laboratory parameters in TB patients requiring intensive care in high-burden regions like China.