From Yonsei U-Korea: Risk factors related with mortality in patients with pulmonary tuberculosis

http://www.ncbi.nlm.nih.gov/pubmed/23101023

Tuberc Respir Dis (Seoul). 2012 Jul;73(1):38-47. doi: 10.4046/trd.2012.73.1.38. Epub 2012 Jul 31.

Risk factors related with mortality in patients with pulmonary tuberculosis.

Kim CW, Kim SH, Lee SN, Lee SJ, Lee MK, Lee JH, Shin KC, Yong SJ, Lee WY.

Source

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.

Abstract

BACKGROUND:

The prevalence rate of pulmonary tuberculosis (PTB) is steadily decreasing in South Korea. However, PTB is a disease with relatively high mortality and morbidity rates throughout Korea. Although there are many studies and statistics about the risk factors of PTB mortality in many countries, there are only a limited number of domestic papers on this topic. The aim of this study is to determine predictive factors for mortality among in-hospital patients associated with PTB.

METHODS:

From December 2006 to January 2011, we reviewed medical records of 2,122 adult patients diagnosed with tuberculosis at a single tertiary hospital in a suburban area. In this study period, 960 patients were diagnosed with PTB by positive Acid fast bacilli smear and/or mycobacterial culture of the respiratory specimen. We compared the groups of patients deceased and patients discharged alive with PTB. The number of dead patients was 82 (47 males, 35 females).

RESULTS:

Mortality was significantly associated with increased values of white blood cells (WBC), blood urine nitrogen (BUN), creatinine, C-reactive protein (CRP), numbers of involved lung field, and length of hospitalization. Also, it was associated with the decreased values of hemoglobin, lymphocyte, sodium, albumin, and cholesterol. Furthermore, admission through the emergency department, initial intensive care unit admission, and drug resistant PTB affected mortality in PTB patients. Independent predictors associated with PTB mortality are BUN, initial intensive care unit care, and admission during treatment of tuberculosis.

CONCLUSION:

In our study, mortality of pulmonary tuberculosis was related with parameters associated with nutritional status, disease severity at the time of admission, and drug resistance.