Prognostic factors in pulmonary tuberculosis requiring mechanical ventilation for acute respiratory failure

Yon Ju Ryu, Won Jung Koh, Eun Hae Kang, Gee Young Suh, Man Pyo Chung, Hojoong Kim, O. Jung Kwon

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

Abstract

Background and objective: The prognosis in patients with pulmonary tuberculosis and acute respiratory failure requiring mechanical ventilation is believed to be poor. The aim of this study was to identify factors contributing to in-hospital mortality in these patients. Methods: The medical records of 32 patients with active pulmonary tuberculosis as a primary cause of acute respiratory failure requiring mechanical ventilation in the medical intensive care unit (ICU) of a tertiary referral hospital over a 10-year period were reviewed retrospectively, and predictors of mortality were assessed. Results: The patients' median age was 69 years (range 25-88 years). The median length of intensive care unit stay was 11 days (range 2-88 days), and the median duration of mechanical ventilation was 9 days (range 2-86 days). Overall in-hospital mortality was 59% (19/32). Independent predictive factors of in-hospital mortality included tuberculous-destroyed lungs (hazard ratio 6.61, 95% CI: 1.21-36.04, P = 0.029), Acute Physiology and Chronic Health Evaluation II scores ≥20 (hazard ratio 4.90, 95% CI: 1.43-16.80, P = 0.012) and sepsis (hazard ratio 5.84, 95% CI: 1.63-20.95, P = 0.007). Conclusion: Acute respiratory failure caused by pulmonary tuberculosis necessitating mechanical ventilation has a high mortality rate and poor prognosis, particularly in patients with tuberculous-destroyed lungs, high Acute Physiology and Chronic Health Evaluation II scores and sepsis.

Original languageEnglish
Pages (from-to)406-411
Number of pages6
JournalRespirology
Volume12
Issue number3
DOIs
StatePublished - May 2007

Keywords

  • Intensive care unit
  • Mechanical ventilation
  • Prognosis
  • Pulmonary tuberculosis
  • Respiratory insufficiency

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