Impact of anemia on prognosis in tuberculosis patients

Luo, Mengxing; Liu, Ming; Wu, Xiaocui; Wu, Yaxing; Yang, Hua; Qin, Lianhua; Yu, Fangyong; Yang, Hu; Z, Liu

doi:10.21037/atm-22-679

Cited by 17 publications

(21 citation statements)

References 32 publications

(40 reference statements)

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“…Our study revealed that CPR and NLR had great predictive power for UTO, as evidenced by AUC values of 0.730 and 0.680, respectively. Lou et al showed that prealbumin and C-reactive protein had significant associations with poor prognosis in anemic TB patients, 12 which was roughly consistent with our research. Additionally, prealbumin could be a sensitive indicator of anemia and malnutrition, 31 , 32 and C-reactive protein has also been discovered to be an effective biomarker for TB-HIV screening.…”

Section: Discussionsupporting

confidence: 92%

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A Scoring System Based on Laboratory Parameters and Clinical Features to Predict Unfavorable Treatment Outcomes in Multidrug- and Rifampicin-Resistant Tuberculosis Patients

Yan

Luo

Nie

et al. 2023

IDR

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Background The growth of antibiotic resistance to Mycobacterium TB represents a major barrier to the goal of “Ending the global TB epidemics”. This study aimed to develop and validate a simple clinical scoring system to predict the unfavorable treatment outcomes (UTO) in multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB) patients. Methods A total of 333 MDR/RR-TB patients were recruited retrospectively. The clinical, radiological and laboratory features were gathered and selected by lasso regression. These variables with area under the receiver operating characteristic curve (AUC)>0.6 were subsequently submitted to multivariate logistic analysis. The binomial logistic model was used for establishing a scoring system based on the nomogram at the training set (N = 241). Then, another independent set was used to validate the scoring system (N = 92). Results The new scoring system consists of age (8 points), education level (10 points), bronchiectasis (4 points), red blood cell distribution width-coefficient of variation (RDW-CV) (7 points), international normalized ratio (INR) (7 points), albumin to globulin ratio (AGR) (5 points), and C-reactive protein to prealbumin ratio (CPR) (6 points). The scoring system identifying UTO has a discriminatory power of 0.887 (95% CI=0.835–0.939) in the training set, and 0.805 (95% CI=0.714–0.896) in the validation set. In addition, the scoring system is used exclusively to predict the death of MDR/RR-TB and has shown excellent performance in both training and validation sets, with AUC of 0.930 (95% CI=0.872–0.989) and 0.872 (95% CI=0.778–0.967), respectively. Conclusion This novel scoring system based on seven accessible predictors has exhibited good predictive performance in predicting UTO, especially in predicting death risk.

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Section: Discussionsupporting

confidence: 92%

“…RDW-CV was proven to have significant associations with poor prognosis in anemic TB patients. 12 Moreover, the lower albumin to globulin ratio (AGR) may be used to predict unfavorable outcomes due to the links between immunoreactivity and malnutrition. 11 The role of coagulation function in TB has attracted increasing attention.…”

Section: Discussionmentioning

confidence: 99%

A Scoring System Based on Laboratory Parameters and Clinical Features to Predict Unfavorable Treatment Outcomes in Multidrug- and Rifampicin-Resistant Tuberculosis Patients

Yan

Luo

Nie

et al. 2023

IDR

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“…In addition, TB causes loss of appetite, thereby reducing the energy income in the patient’s body. Furthermore, TB reduces ferritin absorption, resulting in microcytic anemia [ 9 ]. Hence, although a patient may have an appropriate number of red blood cells, their hemoglobin level is still low; thus, we used a hemoglobin test rather than a red blood cell count to assess TB anemia more reliably.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, adequate tests are necessary to confirm that the tubercle bacilli have been killed following the treatment. Monitoring the patient's blood tests is one of the prognostic methods for lung TB [9][10][11][12]. If the patient has recovered from anemia and the serum C-reactive protein (CRP) level is significantly reduced, then the results indicate that the tubercle bacilli have been eradicated.…”

Section: Introductionmentioning

confidence: 99%

Do Changes in Hemoglobin and C-Reactive Protein Levels in Patients With Hip Tuberculosis After Two Months of Treatment Predict Tubercle Bacilli Deletion?

Dang¹,

Xuan²

2022

Cureus

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Background and objective Tuberculosis (TB) of the hip refers to the hip infection caused by tubercle bacilli. Treatment for hip TB includes anti-TB medications, surgery to remove joint abscesses, and orthopedic surgery. It is necessary to conduct tests to confirm that the tubercle bacilli have been eradicated following the treatments. In this study, we aimed to assess the change in hemoglobin and C-reactive protein (CRP) serum levels in patients with hip TB before and two months after receiving specific treatments. We sought to determine whether they are significant tests for the treatment prognosis of hip TB. Methods We employed a prospective cohort design for this study. It was conducted at National Lung Hospital, Hanoi, and involved 24 hip TB patients with intra-articular abscesses who were treated at the center during the period from October 2016 to October 2021. Blood hemoglobin, CRP serum level, and abscesses on hip MRI were assessed before and two months after treatments. Hemoglobin was examined by spectrophotometry, and CRP serum was measured using the immunoturbidimetric method. Results Before treatments, the average hemoglobin level in the patients was 11.48 ± 1.85 g/dl; the average CRP serum level was 63.53 ± 36.47 mg/l. After two months of treatments, the average hemoglobin level increased significantly to 13.22 ± 1.36 g/dl, while the average CRP level reduced significantly to 12.55 ± 11.34 mg/l. However, five cases displayed abnormal findings. These five individuals continued to have intra-articular abscesses. Conclusion In individuals who reacted well to the therapy, blood hemoglobin and CRP serum levels improved. Blood hemoglobin and serum CRP assays can be utilized to monitor outcomes in hip TB therapy.

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“…Anemia is functionally defined as insufficiency of erythrocyte mass to deliver oxygen in sufficient amount to peripheral tissues 6 . The effects of anemia is diverse among people with TB such as a risk factor for the development of TB 7 and is associated with TB complications including lung injury and poor prognosis such as poor sputum conversion 2 months after TB treatment initiation and also an increased risk of deaths 8 – 11 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence and types of anemia among people with tuberculosis in Africa: a systematic review and meta-analysis

Abaynew

Ahmed

Taye

et al. 2023

Sci Rep

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Globally, tuberculosis (TB) and anemia are public health problems related with high morbidity and mortality. Furthermore, anemia is frequently manifested among people with TB in Africa, prevalence ranging from 25 to 99%. The presence of anemia is associated with an increase in individuals’ susceptibility to TB and poor treatment outcomes. Studies have reported heterogeneous estimate of prevalence of anemia among people with TB in Africa. This review aimed to estimate the prevalence of anemia among newly diagnosed people with TB n Africa. We searched studies in Medline/PubMed, Cochrane library, ScienceDirect, JBI database, the Web of Science, Google Scholar, WorldCat, Open Grey, Scopus, Agency for Healthcare Research and Quality, ProQuest, and African Journals Online that reported the prevalence of anemia at TB diagnosis. Two reviewers performed data extraction with pre-defined inclusion criteria. A random-effects logistic regression model was used to pool the prevalence of anemia and levels of anemia with a 95% confidence interval (CI) in STATA version 14. Heterogeneity and publication biases were explored. A total of 1408 studies were initially identified, and seventeen studies with 4555 people with TB were included in the analysis. The prevalence of anemia among people with TB in Africa was 69% (95% CI 60.57–77.51). The pooled prevalence of anemia of chronic disease was 48% (95% CI 13.31–82.75) and normocytic normochromic anemia was 32% (95% CI 13.74–50.94) while mild anemia was 34% (95% CI 20.44–46.86). Females were more anemic than males at TB diagnosis in Africa (74% vs. 66%). The finding indicates that anemia is a common co-morbidity present among people with TB, especially among females. Mild anemia and normocytic normochromic anemia were more common at TB diagnosis. The finding indicates that anemia is a common co-morbidity present among people with TB in Africa region. Hence, it is recommended to instigate a routine anemia screening at TB diagnosis to improve treatment outcomes.

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Impact of anemia on prognosis in tuberculosis patients

Cited by 17 publications

References 32 publications

A Scoring System Based on Laboratory Parameters and Clinical Features to Predict Unfavorable Treatment Outcomes in Multidrug- and Rifampicin-Resistant Tuberculosis Patients

A Scoring System Based on Laboratory Parameters and Clinical Features to Predict Unfavorable Treatment Outcomes in Multidrug- and Rifampicin-Resistant Tuberculosis Patients

Do Changes in Hemoglobin and C-Reactive Protein Levels in Patients With Hip Tuberculosis After Two Months of Treatment Predict Tubercle Bacilli Deletion?

Prevalence and types of anemia among people with tuberculosis in Africa: a systematic review and meta-analysis

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