Abstract
Introduction: Pulmonary tuberculosis (PTB) is the leading cause of death in the world from a single infectious disease. Patients with severe PTB requiring intensive care unit (ICU) are rare. However, the outcome is poor with high mortality rate, among patients with acute respiratory failure.
Objectives: The study aims to describe the clinical characteristics and outcome of patients with PTB requiring ICU in our center and to identify the risk factors associated with in-hospital mortality.
Methods: We conducted a retrospective study, between January 2012 and May 2012. Patients with smear positive PTB admitted to ICU, Kuala Lumpur General Hospital were enrolled. Clinical data were collected based on individual patient's notes.
Results: A total of 18 active PTB patients (10 male and 8 females) were analyzed in the study. The median age was 42.5 years, ranges from 20 to 68. Average duration of symptom was 2 months. Co-infection with human immunodeficiency virus was present in 4 (22.2%) patients. Median of Simplified Acute Physiology Score (SAPS) II score at admission was 33 (IQR 24-50) and the risk of hospital death was 30.3 (IQR 11-61). Out of 18 patients with acute respiratory failure, 15 (83.4%) were ventilated. The in-ICU mortality rate was 50%, 9 patients died of complications. We had found significant correlation between PaO2/FiO2 ratio, systolic blood pressure (SBP), serum sodium, present of multi-organ failure and advanced radiological findings with the patients' outcome.
Conclusion: We found a high mortality rate in patients with active PTB, requiring intensive care and ventilator support. Few risk factors associated with a poor outcome were identified.
- © 2014 ERS