ERJ
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
QUICK SEARCH:   [advanced]


     

Published online before print May 28, 2008
Eur Respir J 2008, doi:10.1183/09031936.00174907
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
32/4/1031    most recent
09031936.00174907v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Permissions
Right arrowRequest Permissions
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kim, D.K.
Right arrow Articles by Lee, J-H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kim, D.K.
Right arrow Articles by Lee, J-H.

ORIGINAL ARTICLE

Nutritional deficit as a negative prognostic factor in patients with miliary tuberculosis

D.K. Kim 1, H.J. Kim 2, S-Y. Kwon 3, H-i. Yoon 3, C-T. Lee 3, Y.W. Kim 2, H.S. Chung 1, S.K. Han 2, Y-S. Shim 2, J-H. Lee 3*

1 Division of Pulmonology and Critical Care Medicine, Dept of Internal Medicine, Seoul National University Hospital affiliated Boramae Hospital
2 Division of Pulmonary and Critical Care Medicine, Dept of Internal Medicine and Lung Institute, Seoul National University Hospital
3 Division of Pulmonology and Critical Care Medicine, Dept of Internal Medicine, Seoul National University Bundang Hospital

* To whom correspondence should be addressed. E-mail: jhlee7{at}snubh.org.


  Abstract

The effects of malnutrition on outcomes in miliary tuberculosis (MTB) are not well described. We aimed to find predictors for the development of acute respiratory failure (ARF) and survival in MTB patients focusing on parameters reflecting nutritional condition.

Of patients from three hospitals with tuberculosis confirmed microbiologically or histopathologically, 56 patients presenting with typical disseminated pulmonary nodules on radiograph were retrospectively enrolled. A 4-points nutritional risk score (NRS) was defined according to the presence of four nutritional factors such as low BMI (<18.5 kg·m-2), hypoalbuminemia (<30.0 g·L-1), hypocholesterolemia (<2.33 mmol·L-1), and severe lymphocytopenia (<7x105cells·L-1).

The male to female ratio was 1.3. ARF developed in 25% (14/56) with a 50% fatality rate. A high NRS (≥3 points) was an independent risk factor for the development of ARF and fatality (p<0.005). In 90-day survival analysis, ARF, severe lymphocytopenia, hypocholesterolemia, low BMI, and higher NRS were risk factors for poor outcome (p<0.005). In multivariate analysis, only high NRS was an independent risk factor for 90-day survival rate in patients with MTB (p=0.024).

A high NRS was a good predictor of poor outcome in MTB patients. Additional approaches to recovery the nutritional deficits may become a focus in future management of MTB.

Keywords:  Acute respiratory failure, malnutrition, miliary tuberculosis, prognosis




This article has been cited by other articles:


Home page
 Eur Respir JHome page
I. Giovannini, C. Chiarla, F. Giuliante, M. Vellone, F. Ardito, G. Clemente, and G. Nuzzo
To the Editors
Eur. Respir. J., December 1, 2008; 32(6): 1664 - 1665.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
C. C. Leung and W. W. Yew
To the Editors
Eur. Respir. J., December 1, 2008; 32(6): 1663 - 1664.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Copyright © 2008 by the European Respiratory Society.