Clinical outcomes and prognostic factors in patients with tuberculous destroyed lung
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.
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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