Retrospective Analysis of the Treatment Management and Clinical Outcomes of Critically Ill Tuberculosis Patients in the Intensive Care Unit

Yüksel R. C., Alkan M., Aydın K., Sipahioğlu H., Temel Ş., Yetkin N. A., ...Daha Fazla

Journal of clinical practice and research, cilt.46, sa.5, ss.491-499, 2024 (Hakemli Dergi) identifier

Özet

Objective: Tuberculosis (TB) has emerged as a significant cause of morbidity and mortality within intensive care units (ICUs). This study evaluates the clinical characteristics and treatment processes of TB patients in ICUs to inform management strategies. Materials and Methods: This multicenter retrospective study assessed newly diagnosed TB cases admitted to ICUs between January 2019 and January 2024. The primary outcome was mortality rates, while secondary outcomes included clinical characteristics affecting mortality. Medical records from six hospitals were reviewed for active TB patients with confirmed diagnoses. Results: Among 67 ICU patients studied, 34 (51%) died. Significant associations with increased mortality were found for lower Glasgow Coma Scale scores (GCS) (p=0.003), higher Sequential Organ Failure Assessment (SOFA) scores (p=0.020), and elevated Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (p=0.004). Mortality rates were notably higher in patients with multiple comorbidities and nutritional deficiencies. Cox regression analysis identified the Charlson Comorbidity Index (hazard ratio [HR]=1.35, p=0.031) and modified Nutrition Risk in Critically Ill (mNUTRIC) score (HR=1.39, p=0.0483) as significant mortality predictors. Kaplan-Meier analysis indicated that patients with high mNUTRIC scores had significantly lower survival probabilities (p=0.004). Conclusion: Approximately half of the ICU patients with TB died during hospitalization. This study highlights nutritional deficiencies as a key mortality predictor, aiding in the development of improved treatment strategies for TB patients in critical care settings.