Acute respiratory distress syndrome caused by miliary tuberculosis: a multicentre survey in South Korea
Abstract:BACKGROUND: Miliary tuberculosis (TB) is an unusual cause of acute respiratory distress syndrome (ARDS).
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: August 1, 2011
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.
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