Characteristics and outcome of patients with active pulmonary tuberculosis requiring intensive care

¹ Dept of Chest and Infectious Diseases, Helios Klinikum Emil von Behring, affiliated Freie Universität Berlin
² Microbiological Dept, Helios Klinikum Emil von Behring, affiliated Freie Universität Berlin

^* To whom correspondence should be addressed. E-mail: r.erbes{at}zevb.de.

	Abstract

Severe tuberculosis (TB) requiring intensive care unit (ICU)-care is rare but commonly known to be of markedly bad prognosis. Our study aimed to describe this condition and to determine the mortality rate and risk factors associated to mortality.

Patients with confirmed TB admitted to ICU between 1990 and 2001 were retrospectively identified and enrolled. Clinical, radiological and bacteriological data at admission and during hospital stay were recorded. A multivariate analysis was performed to identify the predictive factors for mortality.

A total of 58 TB patients (12 females, mean age 48 yrs) admitted to ICU were included. Mean APACHE II score at admission was 13.1±5.6 and 22/58 (37.9%) patients required mechanical ventilation. The in-hospital mortality was 15/58 (25.9%), of which 13 (22.4%) patients died in the ICU. The mean survival of patients who died was 53.6 days (range 1-229) with 50% of the patients dying within the first 32 days. The factors independently associated with mortality were: acute renal failure (p<0.001), need for mechanical ventilation (p=0.002), chronic pancreatitis (p=0.001), sepsis (p=0.001), ARDS (p=0.008), and nosocomial pneumonia (p=0.002).

These data indicate a high mortality of patients with TB requiring ICU-care and identifies new independently associated risk factors.

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