In-hospital outcome of patients with culture-confirmed tuberculous pleurisy: Confirmedlinical impact of pulmonary involvement
Journal
BMC Infectious Diseases
Journal Volume
11
Pages
46
Date Issued
2011
Abstract
Background: Outcomes for hospitalized patients with tuberculous pleurisy (TP) have rarely been reported, and whether or not pulmonary involvement affects outcomes is uncertain. This study aimed to analyze the in-hospital mortality rate of culture-confirmed TP with an emphasis on the clinical impact of pulmonary involvement.Methods: Patients who were hospitalized for pleural effusion (PE) of unconfirmed diagnosis and finally diagnosed as TP were identified. We classified them according to the disease extent: isolated pleurisy (isolated pleurisy group) and pleurisy with pulmonary involvement (pleuro-pulmonary group).Results: Among the 205 patients hospitalized before the diagnosis was established, 51 (24.9%) belonged to the isolated pleurisy group. Compared to the pleuro-pulmonary group, patients in the isolated pleurisy group were younger, had fewer underlying co-morbidities, and presented more frequently with fever and chest pain. Fewer patients in the isolated pleurisy group had hypoalbuminemia (< 3.5 g/dL) and anemia. The two groups were similar with regards to PE analysis, resistance pattern, and timing of anti-tuberculous treatment. Patients who had a typical pathology of TP on pleural biopsy received anti-tuberculous treatment earlier than those who did not, and were all alive at discharge. The isolated pleurisy group had a lower in-hospital mortality rate, a shorter length of hospital stay and better short-term survival. In addition, the presence of underlying comorbidities and not receiving anti-tuberculous treatment were associated with a higher in-hospital mortality rate.Conclusion: In culture-confirmed tuberculous pleurisy, those with pulmonary involvement were associated with a higher in-hospital mortality rate. A typical pathology for TP on pleura biopsy was associated with a better outcome. ? 2011 Shu et al; licensee BioMed Central Ltd.
SDGs
Other Subjects
albumin; ethambutol; isoniazid; pyrazinamide; rifampicin; adult; age; aged; antibiotic therapy; article; cause of death; clinical assessment; clinical evaluation; comorbidity; controlled study; differential diagnosis; female; fever; gastrointestinal hemorrhage; granulomatous inflammation; histopathology; hospital discharge; hospital patient; human; Human immunodeficiency virus infection; hypoalbuminemia; length of stay; lung tuberculosis; major clinical study; male; multidrug resistant tuberculosis; multiple organ failure; Mycobacterium tuberculosis; outcome assessment; patient care; pleura biopsy; pleura effusion; prognosis; respiratory failure; retrospective study; sex difference; sputum culture; survival rate; thorax pain; tuberculous pleurisy; biopsy; hospital; isolation and purification; lung; lung tuberculosis; middle aged; mortality; Mycobacterium tuberculosis; pathology; pleura; treatment outcome; tuberculous pleurisy; Adult; Aged; Aged, 80 and over; Biopsy; Female; Hospitals; Humans; Lung; Male; Middle Aged; Mycobacterium tuberculosis; Pleura; Treatment Outcome; Tuberculosis, Pleural; Tuberculosis, Pulmonary
Type
journal article