Abstract

OBJECTIVES: To determine predictive factors for mortality among pulmonary tuberculosis (PTB) patients without human immunodeficiency virus (HIV) infection and in need of mechanical ventilation (TBMV). METHODS: From July 2004 to December 2005, 612 respiratory failure patients requiring mechanical ventilation were admitted to the intensive care unit (ICU) of Chang Gung Memorial Hospital, Taipei, Taiwan. Of these, 59 non-HIV-infected patients had active PTB as the primary cause. Mortality rates were measured in TBMV patients and predictors were investigated. Incidence of treatment delay for nosocomial pneumonia was compared between survivors and fatalities. RESULTS: Of the 59 patients with TBMV, 40 (67.8%) died in the ICU. Multi-organ failure syndrome (OR 8.59, 95%CI 1.85-101.27) and nosocomial pneumonia (OR 5.77, 95%CI 1.33-44.36) were independently associated with in-hospital mortality. Treatment delay >24 h for nosocomial pneumonia was significantly more frequent among fatalities than among survivors (19/26, 73.1% vs. 0/3, 0%; P = 0.033). CONCLUSION: Nosocomial pneumonia in TB patients with respiratory failure is associated with a poor prognosis; this appears to be further aggravated by delays in appropriate treatment. Measures to prevent nosocomial pneumonia should be carefully instituted and treatment for nosocomial pneumonia should be started promptly among such patients.

Original languageEnglish
Pages (from-to)335-340
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume13
Issue number3
Publication statusPublished - Mar 2009

Fingerprint

Pulmonary Tuberculosis
Respiratory Insufficiency
Pneumonia
Viruses
Mortality
Artificial Respiration
Intensive Care Units
Survivors
Virus Diseases
Therapeutics
Hospital Mortality
Taiwan
HIV
Incidence

Keywords

  • Mycobacterium tuberculosis
  • Nosocomial infection
  • Pneumonia

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Predictive factors for mortality among non-HIV-infected patients with pulmonary tuberculosis and respiratory failure. / Lin, S. M.; Wang, T. Y.; Liu, W. T.; Chang, C. C.; Lin, H. C.; Liu, C. Y.; Wang, C. H.; Huang, C. D.; Lee, K. Y.; Kuo, Han Pin.

In: International Journal of Tuberculosis and Lung Disease, Vol. 13, No. 3, 03.2009, p. 335-340.

Research output: Contribution to journalArticle

Lin, S. M. ; Wang, T. Y. ; Liu, W. T. ; Chang, C. C. ; Lin, H. C. ; Liu, C. Y. ; Wang, C. H. ; Huang, C. D. ; Lee, K. Y. ; Kuo, Han Pin. / Predictive factors for mortality among non-HIV-infected patients with pulmonary tuberculosis and respiratory failure. In: International Journal of Tuberculosis and Lung Disease. 2009 ; Vol. 13, No. 3. pp. 335-340.
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abstract = "OBJECTIVES: To determine predictive factors for mortality among pulmonary tuberculosis (PTB) patients without human immunodeficiency virus (HIV) infection and in need of mechanical ventilation (TBMV). METHODS: From July 2004 to December 2005, 612 respiratory failure patients requiring mechanical ventilation were admitted to the intensive care unit (ICU) of Chang Gung Memorial Hospital, Taipei, Taiwan. Of these, 59 non-HIV-infected patients had active PTB as the primary cause. Mortality rates were measured in TBMV patients and predictors were investigated. Incidence of treatment delay for nosocomial pneumonia was compared between survivors and fatalities. RESULTS: Of the 59 patients with TBMV, 40 (67.8{\%}) died in the ICU. Multi-organ failure syndrome (OR 8.59, 95{\%}CI 1.85-101.27) and nosocomial pneumonia (OR 5.77, 95{\%}CI 1.33-44.36) were independently associated with in-hospital mortality. Treatment delay >24 h for nosocomial pneumonia was significantly more frequent among fatalities than among survivors (19/26, 73.1{\%} vs. 0/3, 0{\%}; P = 0.033). CONCLUSION: Nosocomial pneumonia in TB patients with respiratory failure is associated with a poor prognosis; this appears to be further aggravated by delays in appropriate treatment. Measures to prevent nosocomial pneumonia should be carefully instituted and treatment for nosocomial pneumonia should be started promptly among such patients.",
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author = "Lin, {S. M.} and Wang, {T. Y.} and Liu, {W. T.} and Chang, {C. C.} and Lin, {H. C.} and Liu, {C. Y.} and Wang, {C. H.} and Huang, {C. D.} and Lee, {K. Y.} and Kuo, {Han Pin}",
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AU - Lin, S. M.

AU - Wang, T. Y.

AU - Liu, W. T.

AU - Chang, C. C.

AU - Lin, H. C.

AU - Liu, C. Y.

AU - Wang, C. H.

AU - Huang, C. D.

AU - Lee, K. Y.

AU - Kuo, Han Pin

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N2 - OBJECTIVES: To determine predictive factors for mortality among pulmonary tuberculosis (PTB) patients without human immunodeficiency virus (HIV) infection and in need of mechanical ventilation (TBMV). METHODS: From July 2004 to December 2005, 612 respiratory failure patients requiring mechanical ventilation were admitted to the intensive care unit (ICU) of Chang Gung Memorial Hospital, Taipei, Taiwan. Of these, 59 non-HIV-infected patients had active PTB as the primary cause. Mortality rates were measured in TBMV patients and predictors were investigated. Incidence of treatment delay for nosocomial pneumonia was compared between survivors and fatalities. RESULTS: Of the 59 patients with TBMV, 40 (67.8%) died in the ICU. Multi-organ failure syndrome (OR 8.59, 95%CI 1.85-101.27) and nosocomial pneumonia (OR 5.77, 95%CI 1.33-44.36) were independently associated with in-hospital mortality. Treatment delay >24 h for nosocomial pneumonia was significantly more frequent among fatalities than among survivors (19/26, 73.1% vs. 0/3, 0%; P = 0.033). CONCLUSION: Nosocomial pneumonia in TB patients with respiratory failure is associated with a poor prognosis; this appears to be further aggravated by delays in appropriate treatment. Measures to prevent nosocomial pneumonia should be carefully instituted and treatment for nosocomial pneumonia should be started promptly among such patients.

AB - OBJECTIVES: To determine predictive factors for mortality among pulmonary tuberculosis (PTB) patients without human immunodeficiency virus (HIV) infection and in need of mechanical ventilation (TBMV). METHODS: From July 2004 to December 2005, 612 respiratory failure patients requiring mechanical ventilation were admitted to the intensive care unit (ICU) of Chang Gung Memorial Hospital, Taipei, Taiwan. Of these, 59 non-HIV-infected patients had active PTB as the primary cause. Mortality rates were measured in TBMV patients and predictors were investigated. Incidence of treatment delay for nosocomial pneumonia was compared between survivors and fatalities. RESULTS: Of the 59 patients with TBMV, 40 (67.8%) died in the ICU. Multi-organ failure syndrome (OR 8.59, 95%CI 1.85-101.27) and nosocomial pneumonia (OR 5.77, 95%CI 1.33-44.36) were independently associated with in-hospital mortality. Treatment delay >24 h for nosocomial pneumonia was significantly more frequent among fatalities than among survivors (19/26, 73.1% vs. 0/3, 0%; P = 0.033). CONCLUSION: Nosocomial pneumonia in TB patients with respiratory failure is associated with a poor prognosis; this appears to be further aggravated by delays in appropriate treatment. Measures to prevent nosocomial pneumonia should be carefully instituted and treatment for nosocomial pneumonia should be started promptly among such patients.

KW - Mycobacterium tuberculosis

KW - Nosocomial infection

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