H-J Kim1, C-H Lee, S Shin, J H Lee, Y W Kim, H S Chung, S K Han, Y-S Shim, D K Kim. 1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Abstract
SETTING: A metropolitan governmental medical centre, Seoul, Republic of Korea. OBJECTIVE: To elucidate the impact of the nutritional deficit assessed by the Nutritional Risk Score (NRS) on the outcomes of in-patients with pulmonary tuberculosis (PTB). DESIGN: All hospitalised patients with microbiologically confirmed PTB were enrolled. A four-point NRS included low body mass index (<18.5 kg/m(2)), hypoalbuminaemia (<30.0 g/l), hypocholesterolaemia (<2.33 mmol/l) and severe lymphocytopaenia (<7 x 10(5) cells/l). The primary outcome was overall in-hospital mortality. The degree of radiographical resolution after anti-tuberculosis treatment was also evaluated. RESULTS: In a total of 156 patients, the male to female ratio was 1.6:1. The overall mortality was 13.5% and tuberculosis-specific fatality was 3.9%. Predisposing factors and high NRS (> or = 3 points) were independent risk factors for in-hospital death after adjusting for the severity of PTB. High NRS (OR = 16.8, P < 0.001) and predisposing factors (OR = 5.4, P = 0.032) were independent risk factors for 30-day survival. The NRS was not associated with radiographic improvement. CONCLUSION: Regardless of disease severity, the high NRS was a significant negative predictor among in-patients with PTB; this finding should therefore be considered in the management of PTB despite the current era of effective anti-tuberculosis chemotherapy.
SETTING: A metropolitan governmental medical centre, Seoul, Republic of Korea. OBJECTIVE: To elucidate the impact of the nutritional deficit assessed by the Nutritional Risk Score (NRS) on the outcomes of in-patients with pulmonary tuberculosis (PTB). DESIGN: All hospitalised patients with microbiologically confirmed PTB were enrolled. A four-point NRS included low body mass index (<18.5 kg/m(2)), hypoalbuminaemia (<30.0 g/l), hypocholesterolaemia (<2.33 mmol/l) and severe lymphocytopaenia (<7 x 10(5) cells/l). The primary outcome was overall in-hospital mortality. The degree of radiographical resolution after anti-tuberculosis treatment was also evaluated. RESULTS: In a total of 156 patients, the male to female ratio was 1.6:1. The overall mortality was 13.5% and tuberculosis-specific fatality was 3.9%. Predisposing factors and high NRS (> or = 3 points) were independent risk factors for in-hospital death after adjusting for the severity of PTB. High NRS (OR = 16.8, P < 0.001) and predisposing factors (OR = 5.4, P = 0.032) were independent risk factors for 30-day survival. The NRS was not associated with radiographic improvement. CONCLUSION: Regardless of disease severity, the high NRS was a significant negative predictor among in-patients with PTB; this finding should therefore be considered in the management of PTB despite the current era of effective anti-tuberculosis chemotherapy.
Authors: Chang-Hoon Lee; Yun-Jeong Jeong; Eun Young Heo; Jong Sun Park; Ji Sun Lee; Byoung Jun Lee; Young Sik Park; Eun Hee Song; Yun Jung Yang; Young Soo Cho; En-hi Cho; Kyoung-in Na; Eun-Jeong Oh; Jin-beom Lee; Soo-Yeon Oh; HeeJin Kim; Chang Min Park; Jae-Joon Yim Journal: BMC Public Health Date: 2013-08-05 Impact factor: 3.295
Authors: Grace Lui; Rity Y K Wong; Florence Li; May K P Lee; Raymond W M Lai; Timothy C M Li; Joseph K M Kam; Nelson Lee Journal: PLoS One Date: 2014-03-18 Impact factor: 3.240