Acute respiratory distress syndrome caused by miliary tuberculosis: a multicentre survey in South Korea
OBJECTIVE: To evaluate the clinical characteristics and outcomes of patients with ARDS caused by miliary TB admitted to the intensive care unit (ICU).
DESIGN: A total of 67 patients were enrolled during the period 1999–2008.
RESULTS: The median age of the patients was 56 years (range 17–81), 19 (28.4%) were aged >71 years, and 38 (56.7%) were male. All-cause mortality in the ICU and hospital were respectively 58.2% and 61.2%. Of the total number of enrolled patients, 49 (73.1%) were prescribed anti-tuberculosis medication within 3 days of hospital admission. On the day of ARDS diagnosis (10.0 ± 3.7 vs. 7.4 ± 3.5, P = 0.005), non-survivors had a significantly higher Sequential Organ Failure Assessment (SOFA) score than survivors. Multivariate analysis showed that SOFA score on the day of ARDS diagnosis was a significant predictor of survival (OR 0.809, 95%CI 0.691–0.946, P = 0.008). It was difficult to determine the efficacy of systemic corticosteroids on patient survival.
CONCLUSION: ARDS caused by miliary TB was associated with a high in-hospital mortality rate, with SOFA score on the day of ARDS diagnosis being a valuable prognostic indicator.
Document Type: Regular Paper
Affiliations: 1: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea 2: Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea 3: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea 4: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea 5: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea 6: College of Medicine, Chung-Ang University, Seoul, Korea 7: Department of Internal Medicine, College of Medicine, Catholic University of Daegu, Daegu, Korea 8: Division of Pulmonary, Allergy and Critical Care Medicine, Chuncheon Sacred Heart Hospital, Hallym University School of Medicine, Chuncheon, Korea 9: Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Hallym Medical Center, Hallym University School of Medicine, Anyong, Korea 10: Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Publication date: 2011-08-01
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