Acute tuberculosis in the intensive care unit

Turk J Med Sci. 2015;45(4):882-7. doi: 10.3906/sag-1408-118.

Abstract

Background/aim: The aim of this study was to determine mortality rates and to evaluate clinical features of patients with active tuberculosis (TB) requiring intensive care unit (ICU) admission.

Materials and methods: The medical records of active TB patients requiring ICU admission were retrospectively reviewed over a 5-year period.

Results: Sixteen patients with active TB admitted to the ICU were included in the study. Seven (43.8%) patients died in the ICU The cause of mortality was septic shock in 5 patients and respiratory failure in 2 patients. The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were higher in patients who died (P = 0.012 and 0.048, respectively). Six of the 8 immunosuppressed patients and 1 of the 8 nonimmunosuppressed patients died (P = 0.041). The median mechanical ventilation (MV) duration was longer in patients who died (11 (5-45) days) than in patients who survived (4.5 (3-7) days) (P = 0.036). Seven of the 8 patients with nosocomial infection and/or coinfection died, while all of the patients without additional infection survived (P = 0.01).

Conclusion: Active TB patients admitted to the ICU had higher mortality rates, especially patients with immunosuppression, nosocomial infection, high APACHE II and SOFA scores, and patients receiving MV.

MeSH terms

  • APACHE
  • Acute Disease
  • Cause of Death
  • Comorbidity
  • Critical Illness
  • Cross Infection / epidemiology*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Immunocompromised Host
  • Male
  • Middle Aged
  • Mortality
  • Respiration, Artificial / methods
  • Respiratory Insufficiency* / etiology
  • Respiratory Insufficiency* / therapy
  • Shock, Septic / etiology*
  • Time Factors
  • Tuberculosis* / complications
  • Tuberculosis* / diagnosis
  • Tuberculosis* / mortality
  • Tuberculosis* / physiopathology
  • Tuberculosis* / therapy
  • Turkey / epidemiology