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重症监护病房中的急性肺结核。

Acute tuberculosis in the intensive care unit.

出版信息

Turk J Med Sci. 2015;45(4):882-7. doi: 10.3906/sag-1408-118.

Abstract

BACKGROUND/AIM: The aim of this study was to determine mortality rates and to evaluate clinical features of patients with active tuberculosis (TB) requiring intensive care unit (ICU) admission.

MATERIALS AND METHODS

The medical records of active TB patients requiring ICU admission were retrospectively reviewed over a 5-year period.

RESULTS

Sixteen patients with active TB admitted to the ICU were included in the study. Seven (43.8%) patients died in the ICU The cause of mortality was septic shock in 5 patients and respiratory failure in 2 patients. The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were higher in patients who died (P = 0.012 and 0.048, respectively). Six of the 8 immunosuppressed patients and 1 of the 8 nonimmunosuppressed patients died (P = 0.041). The median mechanical ventilation (MV) duration was longer in patients who died (11 (5-45) days) than in patients who survived (4.5 (3-7) days) (P = 0.036). Seven of the 8 patients with nosocomial infection and/or coinfection died, while all of the patients without additional infection survived (P = 0.01).

CONCLUSION

Active TB patients admitted to the ICU had higher mortality rates, especially patients with immunosuppression, nosocomial infection, high APACHE II and SOFA scores, and patients receiving MV.

摘要

背景/目的:本研究旨在确定死亡率,并评估需要重症监护病房(ICU)入住的活动性肺结核(TB)患者的临床特征。

材料与方法

回顾性分析了 5 年内需要 ICU 入住的活动性 TB 患者的病历。

结果

研究纳入了 16 例需要 ICU 入住的活动性 TB 患者。7 例(43.8%)患者在 ICU 死亡。死亡原因分别为 5 例脓毒性休克和 2 例呼吸衰竭。死亡患者的急性生理学和慢性健康评估 II 评分(APACHE II)和序贯器官衰竭评估(SOFA)评分较高(P = 0.012 和 0.048)。8 例免疫抑制患者中有 6 例和 8 例非免疫抑制患者中有 1 例死亡(P = 0.041)。死亡患者的机械通气(MV)持续时间中位数较长(11(5-45)天),存活患者为 4.5(3-7)天(P = 0.036)。7 例发生医院感染和/或合并感染的患者死亡,而所有无额外感染的患者均存活(P = 0.01)。

结论

需要入住 ICU 的活动性 TB 患者死亡率较高,尤其是免疫抑制、医院感染、高 APACHE II 和 SOFA 评分以及需要 MV 的患者。

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