title: Clinical outcomes and prognostic factors in patients with tuberculous destroyed lung.
abstract: OBJECTIVE
  To characterise the prognosis and identify factors contributing to mortality in patients with tuberculous destroyed lung (TDL).
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  TDL has a poor prognosis, particularly in patients with more extensive lung destruction.
authors.affiliation: 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
authors.forename: Y J
authors.initials: YJ
authors.lastname: Ryu
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.forename: E-M
authors.initials: EM
authors.lastname: Chun
authors.forename: J H
authors.initials: JH
authors.lastname: Chang
authors.forename: S S
authors.initials: SS
authors.lastname: Shim
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006469:Hemoptysis / Q000382:microbiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000382:microbiology / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D018410:Pneumonia, Bacterial / Q000382:microbiology / Q000401:mortality; D011030:Pneumothorax / Q000382:microbiology; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000382:microbiology / Q000401:mortality; D019141:Respiratory System Agents / Q000627:therapeutic use; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality* / Q000628:therapy
chemical_list: D019141:Respiratory System Agents