Predicting Mortality in Patients with Tuberculous Destroyed Lung Receiving Mechanical Ventilation / 결핵및호흡기질환
Tuberculosis and Respiratory Diseases
; : 247-255, 2018.
Article
in En
| WPRIM
| ID: wpr-715611
Responsible library:
WPRO
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 β 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 ≥65 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 ≥3, 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.
Key words
Full text:
1
Index:
WPRIM
Main subject:
Oxygen
/
Partial Pressure
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Prognosis
/
Respiration, Artificial
/
Respiratory Insufficiency
/
Tuberculosis
/
Tertiary Healthcare
/
Logistic Models
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Multivariate Analysis
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Prospective Studies
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Country/Region as subject:
Asia
Language:
En
Journal:
Tuberculosis and Respiratory Diseases
Year:
2018
Type:
Article