Acute tuberculosis in the intensive care unit

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.