KMID : 1044520180810030247
|
|
Tuberculosis and Respiratory Diseases 2018 Volume.81 No. 3 p.247 ~ p.255
|
|
Predicting Mortality in Patients with Tuberculous Destroyed Lung Receiving Mechanical Ventilation
|
|
Kim Won-Young
Kim Mi-Hyun Jo Eun-Jung Eom Jung-Seop Mok Jeong-Ha Kim Ki-Uk Park Hye-Kyung Lee Min-Ki Lee Kwang-Ha
|
|
Abstract
|
|
|
Background: Patients with acute respiratory failure secondary to tuberculous destroyed lung (TDL) have a poor prognosis. The aim of the present retrospective study was to develop a mortality prediction model for TDL patients who require mechanical ventilation.
Methods: Data from consecutive TDL patients who had received mechanical ventilation at a single university-affiliated tertiary care hospital in Korea were reviewed. Binary logistic regression was used to identify factors predicting intensive care unit (ICU) mortality. A TDL on mechanical Ventilation (TDL-Vent) score was calculated by assigning points to variables according to ¥â coefficient values.
Results: Data from 125 patients were reviewed. A total of 36 patients (29%) died during ICU admission. On the basis of multivariate analysis, the following factors were included in the TDL-Vent score: age ¡Ã65 years, vasopressor use, and arterial partial pressure of oxygen/fraction of inspired oxygen ratio <180. In a second regression model, a modified score was then calculated by adding brain natriuretic peptide. For TDL-Vent scores 0 to 3, the 60-day mortality rates were 11%, 27%, 30%, and 77%, respectively (p<0.001). For modified TDL-Vent scores 0 to ¡Ã3, the 60-day mortality rates were 0%, 21%, 33%, and 57%, respectively (p=0.001). For both the TDL-Vent score and the modified TDL-Vent score, the areas under the receiver operating characteristic curve were larger than that of other illness severity scores.
Conclusion: The TDL-Vent model identifies TDL patients on mechanical ventilation with a high risk of mortality. Prospective validation studies in larger cohorts are now warranted.
|
|
KEYWORD
|
|
Mechanical Ventilation, Mortality, Prognosis, Risk, Tuberculosis
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|