Mortality among patients with tuberculosis requiring intensive care: a retrospective cohort study

Denise R Silva,Paulo Tr Dalcin,Luis F Schulz,Marcelo B Gazzana,Diego M Menegotto

doi:10.1186/1471-2334-10-54

Abstract

BackgroundTo describe the characteristics of patients with tuberculosis (TB) requiring intensive care and to identify the factors that predicts in-hospital mortality in a city of a developing country with intermediate-to-high TB endemicity.MethodsWe conducted a retrospective, cohort study, between November 2005 and November 2007. The patients with TB requiring intensive care were included. Predictors of mortality were assessed. The primary outcome was the in-hospital mortality.ResultsDuring the study period, 67 patients with TB required intensive care. Of them, 62 (92.5%) had acute respiratory failure and required mechanical ventilation. Forty-four (65.7%) patients died. Coinfection with human immunodeficiency virus was present in 46 (68.7%) patients. Early intensive care unit admission and ventilator-associated pneumonia were independently associated with the in-hospital mortality.ConclusionsIn this study we found a high mortality rate in TB patients requiring intensive care, especially in those with an early ICU admission.

Highlights

To describe the characteristics of patients with tuberculosis (TB) requiring intensive care and to identify the factors that predicts in-hospital mortality in a city of a developing country with intermediate-to-high TB endemicity
We have found no association between diagnosis of human immunodeficiency virus (HIV) and mortality (p = 0.999), regardless of level of immunosuppression and use of highly active anti-retroviral therapy (HAART)
In this study, we aimed to evaluate, on a retrospective basis, the risk factors associated with mortality among patients with TB requiring intensive care

Summary

Introduction

To describe the characteristics of patients with tuberculosis (TB) requiring intensive care and to identify the factors that predicts in-hospital mortality in a city of a developing country with intermediate-to-high TB endemicity. Across the world tuberculosis (TB) remains an important public health problem, especially in developing countries. One third of the world’s population is infected with Mycobacterium tuberculosis. Brazil is ranking 15th among the 22 high-burden countries that collectively account for 80% of TB cases globally. The incidence of TB was of 50 cases/100,000 population/yr in 2006, and recently reached approximately 100 cases/ 100,000 population in the city of Porto Alegre (southern Brazil) [1]. The annual death rate from TB in Brazil was estimated at 4.0/100,000 population/yr in 2006 [2]

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