Tuberculosis in the intensive care unit: a prospective observational study

Balkema, Cecile A; Irusen, E M; Taljaard, Jantjie; Koegelenberg, Coenraad F.N.

doi:10.5588/ijtld.13.0044

Cited by 36 publications

(55 citation statements)

References 24 publications

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“…This is in line with the described worse TB outcome in hospitalized patients [32,33]. However, in-hospital mortality due to PTB seems underestimated, when those who require advanced respiratory support face a much higher death rate (up to 70%) than subjects with respiratory failure due to other causes [34].…”

Section: Discussionsupporting

confidence: 66%

A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis

et al. 2016

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Tuberculosis imposes high human and economic tolls, including in Europe. This study was conducted to develop a severity assessment tool for stratifying mortality risk in pulmonary tuberculosis (PTB) patients. A derivation cohort of 681 PTB cases was retrospectively reviewed to generate a model based on multiple logistic regression analysis of prognostic variables with 6-month mortality as the outcome measure. A clinical scoring system was developed and tested against a validation cohort of 103 patients. Five risk features were selected for the prediction model: hypoxemic respiratory failure (OR 4.7, 95% CI 2.8-7.9), age 50 years (OR 2.9, 95% CI 1.7-4.8), bilateral lung involvement (OR 2.5, 95% CI 1.4-4.4), 1 significant comorbidity-HIV infection, diabetes mellitus, liver failure or cirrhosis, congestive heart failure and chronic respiratory disease-(OR 2.3, 95% CI 1.3-3.8), and hemoglobin <12 g/dL (OR 1.8, 95% CI 1.1-3.1). A tuberculosis risk assessment tool (TReAT) was developed, stratifying patients with low (score 2), moderate (score 3-5) and high (score 6) mortality risk. The mortality associated with each group was 2.9%, 22.9% and 53.9%, respectively. The model performed equally well in the validation cohort. We provide a new, easy-to-use clinical scoring system to identify PTB patients with high-mortality risk in settings with good healthcare access, helping clinicians to decide which patients are in need of closer medical care during treatment.

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Section: Discussionsupporting

confidence: 66%

A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis

et al. 2016

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“…[2] A simple severity-of-illness score, based on our published dataset as well as other known poor prognostic factors, was subsequently retrospectively applied to the study population's admission data in order to assess its validity.…”

Section: Study Design and Populationmentioning

confidence: 99%

“…[1,2] Previous studies have shown that approximately 1.5% of adults being treated for active TB in academic hospitals develop respiratory failure requiring admission to an intensive care unit (ICU). [3] The mortality rate of patients with acute respiratory failure due to TB is higher than that of patients with respiratory failure due to other causes, and ranges from 40% to 80%.…”

mentioning

confidence: 99%

“…[3] The mortality rate of patients with acute respiratory failure due to TB is higher than that of patients with respiratory failure due to other causes, and ranges from 40% to 80%. [2,[4][5][6] There is still a paucity of data on the determinants of mortality from TB in the ICU. Recent evidence suggests that the Acute Physiology and Chronic Health Evaluation II (APACHE II) score is predictive of patient mortality.…”

mentioning

confidence: 99%

“…Recent evidence suggests that the Acute Physiology and Chronic Health Evaluation II (APACHE II) score is predictive of patient mortality. [2] The APACHE II score needs to be performed after 24 hours of ICU admission, however, and is not validated as a severity-of-illness score in an emergency setting. [7] The aim of this study was to develop and retrospectively validate a simple severity-of-illness score for use in patients with TB requiring ICU admission.…”

mentioning

confidence: 99%

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