In-hospital mortality of pulmonary tuberculosis with acute respiratory failure and related clinical risk factors
Background/objective: Data on acute respiratory failure (ARF) in pulmonary tuberculosis (PTB) patients is limited. This study aims to investigate in-hospital mortality, its clinical risk factors and the accuracy of the existing scoring system in predicting in-hospital mortality. Methods: An observat...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-05-01
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| Series: | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405579421000255 |
| _version_ | 1819086437982666752 |
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| author | Mia Elhidsi Menaldi Rasmin Prasenohadi |
| author_facet | Mia Elhidsi Menaldi Rasmin Prasenohadi |
| author_sort | Mia Elhidsi |
| collection | DOAJ |
| description | Background/objective: Data on acute respiratory failure (ARF) in pulmonary tuberculosis (PTB) patients is limited. This study aims to investigate in-hospital mortality, its clinical risk factors and the accuracy of the existing scoring system in predicting in-hospital mortality. Methods: An observational prospective cohort study involving PTB patients with ARF in tertiary hospital, between January 2017 and December 2018, was conducted. The in-hospital mortality was predicted using the National Early Warning Score 2 (NEWS2), quick Sequential Organ Failure Assessment (qSOFA) and CRB-65. Regression models were run to analyze the clinical risk factors for in-hospital Mortality. Sensitivity and specificity of scoring systems were calculated using a Wilson score interval. Results: A total of 111 subjects were included. Most of subjects were hypoxemic type respiratory failure (68.5%), advanced lesions (62.2%), new cases (70.3%) and pneumonia co-infection (72.1%) patients. Invasive mechanical ventilation was utilized for 29.73% of cases. There were 53 (47.75%) in-hospital mortality cases and its risk factors were intensive phase treatment (3.34 OR; CI95% 1.27–8.78), P/F ratio < 100 (OR 4.30; CI 95% 1.75–10.59) and renal insufficiency (4.09 OR; CI95% 1.46–11.49). The sensitivity and specificity of NEWS2 ≥ 6, qSOFA ≥ 2 and CRB-65 ≥ 2 were 62.26% and 67.24%; 60.38% and 72.41%; 41.51% and 84.48% respectively. Conclusions: Most of PTB with ARF were new cases, advanced lesion and hypoxemic type respiratory failure. Intensive phase treatment, severe hypoxemia and renal insufficiency are independent predictors of in-hospital mortality in PTB patients with ARF. NEWS2, qSOFA and CRB-65 scores were poor to predict the in-hospital mortality. |
| first_indexed | 2024-12-21T21:20:15Z |
| format | Article |
| id | doaj.art-5d7025d239984fd68d79c18194ee6668 |
| institution | Directory Open Access Journal |
| issn | 2405-5794 |
| language | English |
| last_indexed | 2024-12-21T21:20:15Z |
| publishDate | 2021-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| spelling | doaj.art-5d7025d239984fd68d79c18194ee66682022-12-21T18:49:55ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942021-05-0123100236In-hospital mortality of pulmonary tuberculosis with acute respiratory failure and related clinical risk factorsMia Elhidsi0Menaldi Rasmin1 Prasenohadi2Corresponding author.; Department of Pulmonology and Respiratory Medicine Faculty of Medicine, Universitas Indonesia – Persahabatan National Respiratory Referral Hospital, Jakarta, IndonesiaDepartment of Pulmonology and Respiratory Medicine Faculty of Medicine, Universitas Indonesia – Persahabatan National Respiratory Referral Hospital, Jakarta, IndonesiaDepartment of Pulmonology and Respiratory Medicine Faculty of Medicine, Universitas Indonesia – Persahabatan National Respiratory Referral Hospital, Jakarta, IndonesiaBackground/objective: Data on acute respiratory failure (ARF) in pulmonary tuberculosis (PTB) patients is limited. This study aims to investigate in-hospital mortality, its clinical risk factors and the accuracy of the existing scoring system in predicting in-hospital mortality. Methods: An observational prospective cohort study involving PTB patients with ARF in tertiary hospital, between January 2017 and December 2018, was conducted. The in-hospital mortality was predicted using the National Early Warning Score 2 (NEWS2), quick Sequential Organ Failure Assessment (qSOFA) and CRB-65. Regression models were run to analyze the clinical risk factors for in-hospital Mortality. Sensitivity and specificity of scoring systems were calculated using a Wilson score interval. Results: A total of 111 subjects were included. Most of subjects were hypoxemic type respiratory failure (68.5%), advanced lesions (62.2%), new cases (70.3%) and pneumonia co-infection (72.1%) patients. Invasive mechanical ventilation was utilized for 29.73% of cases. There were 53 (47.75%) in-hospital mortality cases and its risk factors were intensive phase treatment (3.34 OR; CI95% 1.27–8.78), P/F ratio < 100 (OR 4.30; CI 95% 1.75–10.59) and renal insufficiency (4.09 OR; CI95% 1.46–11.49). The sensitivity and specificity of NEWS2 ≥ 6, qSOFA ≥ 2 and CRB-65 ≥ 2 were 62.26% and 67.24%; 60.38% and 72.41%; 41.51% and 84.48% respectively. Conclusions: Most of PTB with ARF were new cases, advanced lesion and hypoxemic type respiratory failure. Intensive phase treatment, severe hypoxemia and renal insufficiency are independent predictors of in-hospital mortality in PTB patients with ARF. NEWS2, qSOFA and CRB-65 scores were poor to predict the in-hospital mortality.http://www.sciencedirect.com/science/article/pii/S2405579421000255Acute respiratory failureIn-hospital mortalityPulmonary tuberculosisTuberculosis |
| spellingShingle | Mia Elhidsi Menaldi Rasmin Prasenohadi In-hospital mortality of pulmonary tuberculosis with acute respiratory failure and related clinical risk factors Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Acute respiratory failure In-hospital mortality Pulmonary tuberculosis Tuberculosis |
| title | In-hospital mortality of pulmonary tuberculosis with acute respiratory failure and related clinical risk factors |
| title_full | In-hospital mortality of pulmonary tuberculosis with acute respiratory failure and related clinical risk factors |
| title_fullStr | In-hospital mortality of pulmonary tuberculosis with acute respiratory failure and related clinical risk factors |
| title_full_unstemmed | In-hospital mortality of pulmonary tuberculosis with acute respiratory failure and related clinical risk factors |
| title_short | In-hospital mortality of pulmonary tuberculosis with acute respiratory failure and related clinical risk factors |
| title_sort | in hospital mortality of pulmonary tuberculosis with acute respiratory failure and related clinical risk factors |
| topic | Acute respiratory failure In-hospital mortality Pulmonary tuberculosis Tuberculosis |
| url | http://www.sciencedirect.com/science/article/pii/S2405579421000255 |
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