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Free Content Clinical outcomes and prognostic factors in patients with tuberculous destroyed lung

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OBJECTIVE: To characterise the prognosis and identify factors contributing to mortality in patients with tuberculous destroyed lung (TDL).

DESIGN: Following a retrospective review of clinical data and radiographic findings, 169 patients with TDL were enrolled in this study. All patients were graded on a 4-point scale (field score 1–4) based on the extent of destroyed lung parenchyma on chest radiography.

RESULTS: The mean patient age was 64 years (range 33–90); 103 (61%) were male. The median number of hospitalisations was 1 (range 0–11) during follow-up, with a mean duration of 31 months (range 0–172). Pneumonia developed in 96 patients (57%), while 50 patients (30%) developed acute respiratory failure requiring mechanical ventilation, 37 (22%) haemoptysis, 24 (14%) spontaneous pneumothorax and 22 (13%) reactivation of tuberculosis. Overall mortality was 28% (47/169), with a median survival of 39 months (range 0–176) after diagnosis. TDL-related mortality was 19% (32/169), and a field score ≥3 was the only independent predictor of shorter survival based on a Cox proportional hazards model (HR 3.520, 95%CI 1.51–8.20, P = 0.004).

CONCLUSION: TDL has a poor prognosis, particularly in patients with more extensive lung destruction.
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Keywords: mortality; prognosis; pulmonary tuberculosis

Document Type: Regular Paper

Affiliations: 1: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Medical Center and Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Republic of Korea 2: Department of Radiology, Ewha Medical Center and Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Republic of Korea

Publication date: 2011-02-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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