Contributing factors to mortality rates of pulmonary tuberculosis in intensive care units

Abstract

The mortality of TB patients who needed ICU support remains high. This higher mortality rate seems related to multi-organ failure, requiring invasive mechanical ventilation and high APACHE II scores.

Clinical Aspects and Principles of Management of Tuberculosis

“…In a recent study done on TB patients requiring ICU admission, mortality was 72.5% (Tatar et al 2018).…”

A severity-of-illness score in patients with tuberculosis requiring intensive care

“…[12] Factors significantly associated with mortality in the present study included a higher APACHE II score, hypolbuminaemia and thrombocytopenia, concurring with previous studies. [2,10,11,13] Moreover, Tatar et al [11] and Ryu et al [14] identified an APACHE II score of >18 and >20, respectively, as being predictive of death. The mean APACHE II score of 23.8 (21.2% for survivors v. 26.3% for non-survivors) in our study highlights the high disease acuity in our cohort, a finding consistent with other studies with predominantly mechanically ventilated patients.…”

“…The need for mechanical ventilation in critically ill patients with TB is associated with increased mortality and prolonged ICU and hospital stays. [10] Tatar et al [11] reported a mortal ity rate of 80.5% in 36 of 40 patients requiring mechanical ventilation in an ICU in Turkey, while in India, an ICU mortality rate of 44% was observed in 57 mechanically ventilated patients. [10] We previously reported ICU mortality and hospital mortality of 44% and 59%, respectively.…”

“…The mean APACHE II score of 23.8 (21.2% for survivors v. 26.3% for non-survivors) in our study highlights the high disease acuity in our cohort, a finding consistent with other studies with predominantly mechanically ventilated patients. [2,11] The association between renal failure and TB-related mortality remains conflicting. [17,18] We identified renal failure to be predictive of mortality in accordance with some, but not all, studies.…”

Pulmonary tuberculosis in intensive care setting, with a focus on the use of severity scores, a multinational collaborative systematic review

“…Delays in diagnosis and treatment of pulmonary TB are principal causes of death, especially in patients with acute respiratory failure. 11 , 19 , 20 Early diagnosis and start of effective treatment is needed to prevent ICU admission and complications. 9 It is imperative that the absorption of anti-TB treatment is maximised; a challenge in the critically ill individual.…”