Risk factors for death in tuberculosis patients requiring ICU care

Abstract

The prognostic factor for in-hospital mortality in tuberculosis (TB) patients requiring intensive care unit (ICU) care remains unclear. Therefore, a retrospective study was conducted aiming to estimate the in-hospital mortality rate and the risk factors for mortality in a high-burden setting. All patients with culture-confirmed TB that were admitted to the ICU of the hospital between March 2012 and April 2019 were identified retrospectively. Data, such as demographic characteristics, comorbidities, laboratory measures and mortality, were obtained from medical records. The Cox proportional hazards regression model was used to identify prognostic factors that influence in-hospital mortality. A total of 82 ICU patients with confirmed TB were included in the analysis, and 22 deaths were observed during the hospital stay, 21 patients died in the ICU. In the multivariable model adjusted for sex and age, the levels of serum albumin and white blood cell (WBC) count were significantly associated with mortality in TB patients requiring ICU care (all P < 0.01), the hazard ratios were 0.8 (95% confidence interval (CI): 0.7–0.9) per 1 g/l and 1.1 (95% CI: 1.0–1.2) per 1 × 109/l, respectively. In conclusion, in-hospital mortality remains high in TB patients requiring ICU care. Low serum albumin level and high WBC count significantly impact the risk of mortality in these TB patients in China.

Population study on diagnosis, treatment and outcomes of critically ill patients with tuberculosis (2008–2018)

“…Predictors of hospital mortality were age, high APACHE IV score, mechanical ventilation, vasopressor therapy, RRT and hypoalbuminemia. Hypoalbuminemia is likely reflective of the inflammatory state of acute TB infection or underlying poor nutritional status 5 11 33–38. Like published cohorts, requirement for mechanical ventilation, vasopressor and RRT was associated with lower survival 4 39 40.…”

Health care associated infections, antimicrobial resistance and outcomes in patients admitted to intensive care unit, India: A five-Year retrospective cohort study

“…However, previous studies have also shown no difference in mortality between patients who developed HAIs in the ICU and the group which did not have HAIs [Choudhuri et al, 2017]. Prolonged ICU stays, nosocomial infection with secondary sepsis, and multiple organ dysfunction syndromes were the leading causes of death for nosocomial infection patients in ICU [Dasgupta et al, 2015, Wang et al, 2016.…”

Survival Trend of Tuberculosis Patients and Risk Factors Associated with Mortality and Developing Drug-Resistant Tuberculosis in Hospital Pulau Pinang, Malaysia: A Retrospective Study

“…As a result, elevated WBC counts in TB patients may be related to the severity of lung involvement and provide an estimated risk of mortality [ 11 ]. During TB infection, the body produces leukocytes and macrophages as part of the immune mechanism to defend the body against invading Mycobacterium tuberculosis , which raises the total number of WBC [ 12 ]. The current study findings documented that every 10 3 cells/µL increment in WBC above the normal range increased the risk of death by 1.102.…”