Outcome of active pulmonary tuberculosis patients requiring respiratory intensive care admission

Introduction There are limited data regarding active pulmonary tuberculosis (APTB) patients requiring ICU admission. Aim This study aimed to determine the mortality rate and risk factors associated with mortality in patients with APTB requiring respiratory intensive care unit (RICU) admission. Patients and methods A combined retrospective-prospective study was conducted during the period between January 2009 and December 2010 (retrospective part) and between January and December 2011 (prospective part) on adult patients with APTB admitted to the RICU of Abbassia Chest Hospital for a period of more than 24 h. Demographic, clinical, and therapeutics characteristics as well as outcome (RICU morality) were obtained from the medical records. Results A total of 100 patients (median age 38 years) were included (60 retrospective and 40 prospective). The RICU morality rate was 74%. The overall median length of stay in RICU was 5 days. Respiratory failure was the most common cause of admission. Mechanical ventilation (MV) was needed in 65% of patients. Complications occurred in 45% of cases. Female sex, lower diastolic blood pressure, far advanced lesion, respiratory failure type II, higher Acute Physiology and Chronic Health Evaluation II score, lower Glasgow Coma Scale score, increased need for MV, and electrolytes disturbances were significantly more frequent in nonsurvivors than in survivors in the RICU. Risk factors identified for nonsurvival were pneumonia pattern and far advanced lesion by radiology, female sex, and renal impairment. MV was the only predictor of RICU mortality. Conclusion The present study found a very high mortality rate among APTB patients requiring RICU admission and identified associated risk factors and a predictor of RICU mortality.