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Free Content Mortality and predictors in pulmonary tuberculosis with respiratory failure requiring mechanical ventilation

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OBJECTIVE: To analyse the predictors and mortality rate among patients receiving mechanical ventilation (MV) for respiratory failure due to pulmonary tuberculosis (TB).

DESIGN: We retrospectively compared patients who required MV for TB with patients who required MV for community-acquired pneumonia (CAP).

RESULTS: In-hospital mortality was significantly different between the two groups: 95.1% in TB vs. 62.7% in CAP (P < 0.001 using the χ2 test). TB patients had a higher 30-day mortality (P = 0.040 using log-rank test), although the median sequential organ failure assessment (SOFA) (7.0 vs. 6.0, P = 0.842) and mean Acute Physiology and Chronic Health Evaluation (APACHE) II scores (20.0 ± 6.7 vs. 21.2 ± 6.7, P = 0.379) for TB and CAP patients were not different. TB patients were more likely to have increased lung lesion intrusions (OR 1.307, 95%CI 1.042–1.641, P = 0.021), and reduced albumin (OR 0.073, 95%CI 0.016–0.335, P = 0.001), C-reactive protein (OR 0.324, 95%CI 0.146–0.716, P = 0.005) and CURB-65 score (confusion, uraemia, respiratory rate, blood pressure and age 65 years) (OR 0.916, 95%CI 0.844–0.995, P = 0.037).

CONCLUSIONS: TB patients showed identical SOFA and APACHE II scores, but higher mortality than CAP patients. The higher mortality was not related to severity, but suggested an association with the extent of destructive lung lesions.
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Keywords: Mycobacterium tuberculosis; multi-organ failure; pneumonia

Document Type: Research Article

Affiliations: 1: *Department of Internal Medicine, Seoul Medical Center, Seoul 2: Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon 3: Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea

Publication date: April 1, 2016

More about this publication?
  • 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 lung health world-wide.

    To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal. Read fast-track articles.

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

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