RT Journal Article SR Electronic T1 Outcome of Critically Ill Subjects With Tuberculosis: Systematic Review and Meta-Analysis JF Respiratory Care FD American Association for Respiratory Care SP respcare.06190 DO 10.4187/respcare.06190 A1 Valliappan Muthu A1 Ritesh Agarwal A1 Sahajal Dhooria A1 Ashutosh N Aggarwal A1 Digambar Behera A1 Inderpaul Singh Sehgal YR 2018 UL http://rc.rcjournal.com/content/early/2018/09/11/respcare.06190.abstract AB BACKGROUND: The outcomes of patients with tuberculosis admitted to an ICU remain undetermined. Herein, we reviewed the literature to describe the mortality of subjects with tuberculosis who are critically ill, and explore the effect of glucocorticoids on survival.METHODS: A systematic review of medical literature databases was performed for studies that describe the outcome of subjects with tuberculosis who required ICU admission. We calculated the proportion of hospitalized subjects with tuberculosis who required ICU admission. Pooled estimates of ICU and hospital mortality, and tuberculosis-related ARDS were calculated. We also studied the effect of systemic glucocorticoids on survival of subjects with tuberculosis who were critically ill.RESULTS: A total of 35 studies (N = 1,815) were included. The pooled proportion of hospitalized subjects with tuberculosis who required ICU admission was 3.4% (95% CI 1.6–5.7%). The pooled ICU and hospital mortality was 48% (95% CI 41–55%) and 54% (95% CI 46–62%), respectively. Tuberculosis-related ARDS was associated with higher odds (odds ratio 3.88, 95% CI 1.73–8.72) of death. The use of glucocorticoids was not related to an improvement in survival (odds ratio 0.65, 95% CI 0.27–1.57).CONCLUSIONS: Tuberculosis is a rare cause of ICU admission but is associated with high mortality. Tuberculosis-related ARDS is also associated with lower survival. The role of glucocorticoids in patients with tuberculosis who are critically ill remains unclear and needs further evaluation.