The Impact of Nutritional Deficit on Mortality of In-Patients With Pulmonary Tuberculosis

Int J Tuberc Lung Dis. 2010 Jan;14(1):79-85.

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.

MeSH terms

  • Academic Medical Centers / statistics & numerical data
  • Adult
  • Aged
  • Body Mass Index
  • Female
  • Hospital Mortality
  • Humans
  • Inpatients / statistics & numerical data
  • Korea / epidemiology
  • Male
  • Middle Aged
  • Nutrition Disorders / complications*
  • Radiography
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Tuberculosis, Pulmonary / complications
  • Tuberculosis, Pulmonary / diagnostic imaging
  • Tuberculosis, Pulmonary / mortality*