title: Hypoalbuminemia and lymphocytopenia are predictive risk factors for in-hospital mortality in patients with tuberculosis.
abstract: OBJECTIVE
  The aim of this study was to clarify the association between nutritional state on admission and in-hospital death in tuberculosis (TB) patients, including a high proportion of elderly patients.
  
  
  METHODS
  A retrospective cohort study of 246 TB patients was conducted. The serum albumin concentrations and peripheral blood lymphocyte counts were measured on admission, and the primary outcome of interest was in-hospital death. Patient mortality was categorized into two groups: TB death and non-TB death. A multivariate analysis was performed to evaluate the relationship between nutritional state on admission and in-hospital mortality in TB patients.
  
  
  RESULTS
  The median [interquartile range] patient age was 79 [69-83] years, and the in-hospital death rate was 20.73% (TB death: 26 patients; non-TB death: 25 patients). The multivariate analysis revealed that the serum albumin concentrations (OR: 0.21, 95% CI: 0.10-0.41; p<0.0001) and peripheral blood total lymphocyte counts (Category 2 [627.2-1,106.7/mm(3)] vs. 1 [<627.2/mm(3)]. OR: 0.28, 95% CI: 0.11-0.73; p=0.009, Category 3 [>1,106.7/mm(3)] vs. 1. OR: 0.24, 95% CI: 0.08-0.76, p=0.015) on admission were significantly associated with all in-hospital deaths in the TB patients. The serum albumin concentrations and peripheral blood total lymphocyte counts were also found to be associated with in-hospital deaths directly caused by TB.
  
  
  CONCLUSIONS
  Hypoalbuminemia and lymphocytopenia on admission are predictive risk factors for in-hospital mortality in TB patients. Nutritional defects should thus receive special attention in order to reduce TB patient mortality, particularly among elderly patients.
authors: Department of Respiratory Medicine, National Hospital Organization Omuta National Hospital, Japan. kyoko-k@kokyu.med.kyushu-u.ac.jp
authors: Kyoko
authors: K
authors: Okamura
authors: Nobuhiko
authors: N
authors: Nagata
authors: Kentaro
authors: K
authors: Wakamatsu
authors: Koji
authors: K
authors: Yonemoto
authors: Satoshi
authors: S
authors: Ikegame
authors: Akira
authors: A
authors: Kajiki
authors: Koichi
authors: K
authors: Takayama
authors: Yoichi
authors: Y
authors: Nakanishi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D034141:Hypoalbuminemia / Q000150:complications* / Q000401:mortality*; D008231:Lymphopenia / Q000150:complications* / Q000401:mortality*; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014376:Tuberculosis / Q000150:complications* / Q000401:mortality*