Acute respiratory distress syndrome complicating community-acquired pneumonia secondary to mycobacterium tuberculosis in a tertiary care center in Saudi Arabia
Acute respiratory distress syndrome complicating community-acquired pneumonia secondary to mycobacterium tuberculosis in a tertiary care center in Saudi Arabia
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DOI：
10.15537/smj.2016.9.15183
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发表时间：
2016-09-01
影响因子：
1.6
通讯作者：
Al-Jahdali, Hamdan
中科院分区：
文献类型：
--
作者：
Mahmoud, Ebrahim S.;Baharoon, Salim A.;Al-Jahdali, Hamdan
目的：讨论我们中心在沙特阿拉伯王国一家大型三级转诊医院治疗继发于肺结核 (TB) 的急性呼吸窘迫综合征 (ARDS) 的经验。方法：回顾性审查 2004 年至 2013 年在沙特阿拉伯王国利雅得阿卜杜勒阿齐兹国王医疗城单一中心接受重症监护的所有结核分枝杆菌感染继发社区获得性肺炎患者的病历。结果：我们回顾了重症监护室收治的 350 名社区获得性肺炎患者，发现 11 例结核病并发 ARDS。患者的平均年龄为51.9岁。从入院到肺结核诊断和开始治疗的中位时间为 5 天，从症状出现到开始治疗的中位时间为 18 天。死亡率为64%，死亡前住院时间中位数为21.4天。延迟治疗以及就诊时的高急性生理学和慢性健康评估 II 和 CURB-65 评分是死亡的独立危险因素。结论：肺结核患者很少因符合 ARDS 所有标准的急性症状而接受重症监护。结核病的这种表现具有很高的死亡风险。
Objectives: To discuss our center's experience with acute respiratory distress syndrome (ARDS) secondary to pulmonary tuberculosis (TB) in a major tertiary referral hospital in the Kingdom of Saudi Arabia.Methods: A retrospective review of medical records of all patients with community-acquired pneumonia secondary to mycobacterium TB infection who were admitted for critical care in a single center of King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia from 2004 to 2013.Results: In our review of 350 patients with community-acquired pneumonia admitted to Intensive Care Unit, 11 cases of TB complicated with ARDS were identified. The mean age of patients was 51.9 years. The median time from hospital admission to pulmonary TB diagnosis and start of therapy was 5 days, while the median time from onset of symptoms to initiation of treatment was 18 days. The mortality rate was 64%, and the median length of hospital stay before death was 21.4 days. Delayed treatment, as well as high acute physiology and chronic health evaluation II and CURB-65 scores at presentation, were independent risk factors for death.Conclusion: Patients with pulmonary TB infrequently present to intensive care with acute symptoms that meet all criteria for ARDS. Such a presentation of TB carries a high mortality risk.