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Prognostic factors in pulmonary tuberculosis requiring mechanical ventilation for acute respiratory failure
Author(s) -
RYU Yon Ju,
KOH WonJung,
KANG Eun Hae,
SUH Gee Young,
CHUNG Man Pyo,
KIM Hojoong,
KWON O Jung
Publication year - 2007
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/j.1440-1843.2006.01007.x
Subject(s) - medicine , mechanical ventilation , hazard ratio , intensive care unit , respiratory failure , mortality rate , sepsis , tuberculosis , medical record , emergency medicine , intensive care medicine , confidence interval , pathology
Background and objective: The prognosis in patients with pulmonary tuberculosis and acute respiratory failure requiring mechanical ventilation is believed to be poor. The aim of this study was to identify factors contributing to in‐hospital mortality in these patients. Methods: The medical records of 32 patients with active pulmonary tuberculosis as a primary cause of acute respiratory failure requiring mechanical ventilation in the medical intensive care unit (ICU) of a tertiary referral hospital over a 10‐year period were reviewed retrospectively, and predictors of mortality were assessed. Results: The patients’ median age was 69 years (range 25–88 years). The median length of intensive care unit stay was 11 days (range 2–88 days), and the median duration of mechanical ventilation was 9 days (range 2–86 days). Overall in‐hospital mortality was 59% (19/32). Independent predictive factors of in‐hospital mortality included tuberculous‐destroyed lungs (hazard ratio 6.61, 95% CI: 1.21–36.04, P = 0.029), Acute Physiology and Chronic Health Evaluation II scores ≥20 (hazard ratio 4.90, 95% CI: 1.43–16.80, P = 0.012) and sepsis (hazard ratio 5.84, 95% CI: 1.63–20.95, P = 0.007). Conclusion: Acute respiratory failure caused by pulmonary tuberculosis necessitating mechanical ventilation has a high mortality rate and poor prognosis, particularly in patients with tuberculous‐destroyed lungs, high Acute Physiology and Chronic Health Evaluation II scores and sepsis.