Outcome Predictors of Patients With Pulmonary Tuberculosis in Respiratory Intensive Care

Abstract

PURPOSE: The aim of this study was to evaluate the outcome predictors of patients with pulmonary TB with respiratory failure in respiratory intensive care. METHODS: Thirty-six patients with laboratory confirmed TB were admitted to respiratory ICU in chest department, Mansoura University between January 2006 and July 2009. Demographic, clinical, radiological and bacteriological data at admission and during hospital stay were recorded. Hospital deaths were reported. A univariate and multivariate analysis were performed to identify outcome predictors of mortality. RESULTS: A total of 36 TB patients were recruited in the study (23 males and 13 females) (mean age 51.47 ± 13.45 years) (21 rural and 15 urban). Mean acute physiology and chronic health evaluation (APACHE II) score at admission was 19.53 ± 3.09 for survived and 27.76 ± 3.73 for deaths. The in-hospital mortality was 47.2%, factors significantly related to increase mortality were smoking history, comorbidity, co-existing pulmonary diseases, associated MOF, military or disseminated TB, extensive radiological pulmonary lesions, hyponatreamia, hypoalbumineamia, higher APACHEII score, hypercapnia, elevated Ca levels and need for mechanical ventilation in univariate analysis of predictors. Multivariate analysis identify only hypercapnia and hypercalceamia were the most significant predictors of mortality. CONCLUSION: These data indicate a high mortality of tuberculosis patients admitted to ICU, and suggest that hypercapnia and hypercalceamia were the most significant predictors of mortality in multivariate analysis. CLINICAL IMPLICATIONS: Clinical applecation of new predictors in respiratory ICU for TB cases with respiratory failure.