Table of Contents Author Guidelines Submit a Manuscript
Critical Care Research and Practice
Volume 2017, Article ID 9535463, 9 pages
https://doi.org/10.1155/2017/9535463
Research Article

Severe Tuberculosis Requiring Intensive Care: A Descriptive Analysis

1Infectious Diseases Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, Porto, Portugal
2Instituto de Inovação e Investigação em Saúde (I3S), Grupo de I&D em Nefrologia e Doenças Infecciosas, Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal

Correspondence should be addressed to Raquel Pacheco Duro; moc.liamg@orud.leuqar

Received 4 August 2016; Revised 14 November 2016; Accepted 24 November 2016; Published 30 January 2017

Academic Editor: Robert Boots

Copyright © 2017 Raquel Pacheco Duro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. This study aims to describe the characteristics of tuberculosis (TB) patients requiring intensive care and to determine the in-hospital mortality and the associated predictive factors. Methods. Retrospective cohort study of all TB patients admitted to the ICU of the Infectious Diseases Department of Centro Hospitalar de São João (Porto, Portugal) between January 2007 and July 2014. Comorbid diagnoses, clinical features, radiological and laboratory investigations, and outcomes were reviewed. Univariate analysis was performed to identify risk factors for death. Results. We included 39 patients: median age was 52.0 years and 74.4% were male. Twenty-one patients (53.8%) died during hospital stay (15 in the ICU). The diagnosis of isolated pulmonary TB, a positive smear for acid-fast-bacilli and a positive PCR for Mycobacterium tuberculosis in patients of pulmonary disease, severe sepsis/septic shock, acute renal failure and Multiple Organ Dysfunction Syndrome on admission, the need for mechanical ventilation or vasopressor support, hospital acquired infection, use of adjunctive corticotherapy, smoking, and alcohol abuse were significantly associated with mortality (). Conclusion. This cohort of TB patients requiring intensive care presented a high mortality rate. Most risk factors for mortality were related to organ failure, but others could be attributed to delay in the diagnostic and therapeutic approach, important targets for intervention.