APACHE-II score for anti-tuberculosis tolerance in critically ill patients: a retrospective study
Abstract Background To investigate the status of anti-tuberculosis treatment in critically ill patients, and to explore the value of APACHE-II score in guiding anti-tuberculosis treatment. Methods This analysis included critically ill patients with tuberculosis. The utility of APACHE-II score for pr...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-02-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-019-3751-7 |
| _version_ | 1828851743992053760 |
|---|---|
| author | Junke Qiu Caihong Wang Xiaohong Pan Lei Pan Xiaoqing Huang Jiekun Xu Xiaobo Ji Minjie Mao |
| author_facet | Junke Qiu Caihong Wang Xiaohong Pan Lei Pan Xiaoqing Huang Jiekun Xu Xiaobo Ji Minjie Mao |
| author_sort | Junke Qiu |
| collection | DOAJ |
| description | Abstract Background To investigate the status of anti-tuberculosis treatment in critically ill patients, and to explore the value of APACHE-II score in guiding anti-tuberculosis treatment. Methods This analysis included critically ill patients with tuberculosis. The utility of APACHE-II score for predicting drug withdrawal was evaluated using receiver operating characteristic (ROC) curve analysis. Results Among 320 patients enrolled (58 ± 22 years; 256 males), 147 (45.9%) had drugs withdrawn. The drug withdrawal group had higher APACHE-II score (median [interquartile range]: 21 [3–52] vs. 17 [4–42] points), higher CD4%, lower hemoglobin level, higher rates of chronic obstructive pulmonary disease (COPD) and chronic renal failure, and lower rate of extrapulmonary tuberculosis (P < 0.05). Logistic regression identified APACHE-II score > 18 (odds ratio [95% confidence interval]: 2.099 [1.321–3.334], P < 0.01), COPD (1.913 [1.028–3.561], P < 0.05) and hemoglobin level (0.987 [0.977–0.997], P < 0.05) as independent factors associated with drug withdrawal. At an optimal cutoff of 18.5, the sensitivity, specificity, positive predictive value and negative predictive value of APACHE-II score for predicting drug withdrawal was 59.2, 61.8, 56.9 and 64.1%, respectively. Conclusions APACHE-II score > 18 points might predict patient tolerance of anti-tuberculosis treatment. |
| first_indexed | 2024-12-12T23:37:44Z |
| format | Article |
| id | doaj.art-eebbc2d20ff14d90a5fbea1391b93f71 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T23:37:44Z |
| publishDate | 2019-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-eebbc2d20ff14d90a5fbea1391b93f712022-12-22T00:07:20ZengBMCBMC Infectious Diseases1471-23342019-02-011911810.1186/s12879-019-3751-7APACHE-II score for anti-tuberculosis tolerance in critically ill patients: a retrospective studyJunke Qiu0Caihong Wang1Xiaohong Pan2Lei Pan3Xiaoqing Huang4Jiekun Xu5Xiaobo Ji6Minjie Mao7Department of Tuberculosis Intensive Care Unit, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, Hang Zhou Red Cross HospitalDepartment of Tuberculosis Intensive Care Unit, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, Hang Zhou Red Cross HospitalDepartment of Tuberculosis Intensive Care Unit, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, Hang Zhou Red Cross HospitalDepartment of Tuberculosis Intensive Care Unit, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, Hang Zhou Red Cross HospitalDepartment of Tuberculosis Intensive Care Unit, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, Hang Zhou Red Cross HospitalDepartment of Tuberculosis Intensive Care Unit, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, Hang Zhou Red Cross HospitalDepartment of Tuberculosis Intensive Care Unit, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, Hang Zhou Red Cross HospitalDepartment of Tuberculosis Intensive Care Unit, Tuberculosis Diagnosis and Treatment Center of Zhejiang Province, Hang Zhou Red Cross HospitalAbstract Background To investigate the status of anti-tuberculosis treatment in critically ill patients, and to explore the value of APACHE-II score in guiding anti-tuberculosis treatment. Methods This analysis included critically ill patients with tuberculosis. The utility of APACHE-II score for predicting drug withdrawal was evaluated using receiver operating characteristic (ROC) curve analysis. Results Among 320 patients enrolled (58 ± 22 years; 256 males), 147 (45.9%) had drugs withdrawn. The drug withdrawal group had higher APACHE-II score (median [interquartile range]: 21 [3–52] vs. 17 [4–42] points), higher CD4%, lower hemoglobin level, higher rates of chronic obstructive pulmonary disease (COPD) and chronic renal failure, and lower rate of extrapulmonary tuberculosis (P < 0.05). Logistic regression identified APACHE-II score > 18 (odds ratio [95% confidence interval]: 2.099 [1.321–3.334], P < 0.01), COPD (1.913 [1.028–3.561], P < 0.05) and hemoglobin level (0.987 [0.977–0.997], P < 0.05) as independent factors associated with drug withdrawal. At an optimal cutoff of 18.5, the sensitivity, specificity, positive predictive value and negative predictive value of APACHE-II score for predicting drug withdrawal was 59.2, 61.8, 56.9 and 64.1%, respectively. Conclusions APACHE-II score > 18 points might predict patient tolerance of anti-tuberculosis treatment.http://link.springer.com/article/10.1186/s12879-019-3751-7TuberculosisCritical illnessAPACHE-IIDrug tolerance |
| spellingShingle | Junke Qiu Caihong Wang Xiaohong Pan Lei Pan Xiaoqing Huang Jiekun Xu Xiaobo Ji Minjie Mao APACHE-II score for anti-tuberculosis tolerance in critically ill patients: a retrospective study BMC Infectious Diseases Tuberculosis Critical illness APACHE-II Drug tolerance |
| title | APACHE-II score for anti-tuberculosis tolerance in critically ill patients: a retrospective study |
| title_full | APACHE-II score for anti-tuberculosis tolerance in critically ill patients: a retrospective study |
| title_fullStr | APACHE-II score for anti-tuberculosis tolerance in critically ill patients: a retrospective study |
| title_full_unstemmed | APACHE-II score for anti-tuberculosis tolerance in critically ill patients: a retrospective study |
| title_short | APACHE-II score for anti-tuberculosis tolerance in critically ill patients: a retrospective study |
| title_sort | apache ii score for anti tuberculosis tolerance in critically ill patients a retrospective study |
| topic | Tuberculosis Critical illness APACHE-II Drug tolerance |
| url | http://link.springer.com/article/10.1186/s12879-019-3751-7 |
| work_keys_str_mv | AT junkeqiu apacheiiscoreforantituberculosistoleranceincriticallyillpatientsaretrospectivestudy AT caihongwang apacheiiscoreforantituberculosistoleranceincriticallyillpatientsaretrospectivestudy AT xiaohongpan apacheiiscoreforantituberculosistoleranceincriticallyillpatientsaretrospectivestudy AT leipan apacheiiscoreforantituberculosistoleranceincriticallyillpatientsaretrospectivestudy AT xiaoqinghuang apacheiiscoreforantituberculosistoleranceincriticallyillpatientsaretrospectivestudy AT jiekunxu apacheiiscoreforantituberculosistoleranceincriticallyillpatientsaretrospectivestudy AT xiaoboji apacheiiscoreforantituberculosistoleranceincriticallyillpatientsaretrospectivestudy AT minjiemao apacheiiscoreforantituberculosistoleranceincriticallyillpatientsaretrospectivestudy |