Acute respiratory distress syndrome caused by miliary tuberculosis: a multicentre survey in South Korea

Int J Tuberc Lung Dis. 2011 Aug;15(8):1099-103. doi: 10.5588/ijtld.10.0557.

Abstract

Background: Miliary tuberculosis (TB) is an unusual cause of acute respiratory distress syndrome (ARDS).

Objective: To evaluate the clinical characteristics and outcomes of patients with ARDS caused by miliary TB admitted to the intensive care unit (ICU).

Design: A total of 67 patients were enrolled during the period 1999-2008.

Results: The median age of the patients was 56 years (range 17-81), 19 (28.4%) were aged >71 years, and 38 (56.7%) were male. All-cause mortality in the ICU and hospital were respectively 58.2% and 61.2%. Of the total number of enrolled patients, 49 (73.1%) were prescribed anti-tuberculosis medication within 3 days of hospital admission. On the day of ARDS diagnosis (10.0 ± 3.7 vs. 7.4 ± 3.5, P = 0.005), non-survivors had a significantly higher Sequential Organ Failure Assessment (SOFA) score than survivors. Multivariate analysis showed that SOFA score on the day of ARDS diagnosis was a significant predictor of survival (OR 0.809, 95%CI 0.691-0.946, P = 0.008). It was difficult to determine the efficacy of systemic corticosteroids on patient survival.

Conclusion: ARDS caused by miliary TB was associated with a high in-hospital mortality rate, with SOFA score on the day of ARDS diagnosis being a valuable prognostic indicator.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use
  • Chi-Square Distribution
  • Drug Prescriptions
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Republic of Korea / epidemiology
  • Respiratory Distress Syndrome / drug therapy
  • Respiratory Distress Syndrome / epidemiology*
  • Respiratory Distress Syndrome / microbiology
  • Respiratory Distress Syndrome / mortality
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Survival Analysis
  • Time Factors
  • Treatment Outcome
  • Tuberculosis, Miliary / complications
  • Tuberculosis, Miliary / drug therapy
  • Tuberculosis, Miliary / epidemiology*
  • Tuberculosis, Miliary / microbiology
  • Tuberculosis, Miliary / mortality
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Antitubercular Agents