Y J Ryu1, J H Lee, E-M Chun, J H Chang, S S Shim. 1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Medical Center and Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Republic of Korea. medyon@ewha.ac.kr
Abstract
OBJECTIVE: To characterise the prognosis and identify factors contributing to mortality in patients with tuberculous destroyed lung (TDL). DESIGN: Following a retrospective review of clinical data and radiographic findings, 169 patients with TDL were enrolled in this study. All patients were graded on a 4-point scale (field score 1-4) based on the extent of destroyed lung parenchyma on chest radiography. RESULTS: The mean patient age was 64 years (range 33-90); 103 (61%) were male. The median number of hospitalisations was 1 (range 0-11) during follow-up, with a mean duration of 31 months (range 0-172). Pneumonia developed in 96 patients (57%), while 50 patients (30%) developed acute respiratory failure requiring mechanical ventilation, 37 (22%) haemoptysis, 24 (14%) spontaneous pneumothorax and 22 (13%) reactivation of tuberculosis. Overall mortality was 28% (47/169), with a median survival of 39 months (range 0-176) after diagnosis. TDL-related mortality was 19% (32/169), and a field score ≥ 3 was the only independent predictor of shorter survival based on a Cox proportional hazards model (HR 3.520, 95%CI 1.51-8.20, P = 0.004). CONCLUSION: TDL has a poor prognosis, particularly in patients with more extensive lung destruction.
OBJECTIVE: To characterise the prognosis and identify factors contributing to mortality in patients with tuberculous destroyed lung (TDL). DESIGN: Following a retrospective review of clinical data and radiographic findings, 169 patients with TDL were enrolled in this study. All patients were graded on a 4-point scale (field score 1-4) based on the extent of destroyed lung parenchyma on chest radiography. RESULTS: The mean patient age was 64 years (range 33-90); 103 (61%) were male. The median number of hospitalisations was 1 (range 0-11) during follow-up, with a mean duration of 31 months (range 0-172). Pneumonia developed in 96 patients (57%), while 50 patients (30%) developed acute respiratory failure requiring mechanical ventilation, 37 (22%) haemoptysis, 24 (14%) spontaneous pneumothorax and 22 (13%) reactivation of tuberculosis. Overall mortality was 28% (47/169), with a median survival of 39 months (range 0-176) after diagnosis. TDL-related mortality was 19% (32/169), and a field score ≥ 3 was the only independent predictor of shorter survival based on a Cox proportional hazards model (HR 3.520, 95%CI 1.51-8.20, P = 0.004). CONCLUSION: TDL has a poor prognosis, particularly in patients with more extensive lung destruction.
Authors: Thaddeus L Miller; Fernando A Wilson; Jenny W Pang; Suzanne Beavers; Sally Hoger; Sharon Sharnprapai; Melissa Pagaoa; Dolly J Katz; Stephen E Weis Journal: Am J Public Health Date: 2015-03-19 Impact factor: 9.308
Authors: Jamilah Meghji; Maia Lesosky; Elizabeth Joekes; Peter Banda; Jamie Rylance; Stephen Gordon; Joseph Jacob; Harmien Zonderland; Peter MacPherson; Elizabeth L Corbett; Kevin Mortimer; Stephen Bertel Squire Journal: Thorax Date: 2020-02-26 Impact factor: 9.139
Authors: T Rodrigo; M Casals; J A Caminero; J M García-García; M A Jiménez-Fuentes; J F Medina; J P Millet; J Ruiz-Manzano; J Caylá Journal: PLoS One Date: 2016-08-03 Impact factor: 3.240