title: Predictive factors for unfavorable outcomes of tuberculous pericarditis in human immunodeficiency virus-uninfected patients in an intermediate tuberculosis burden country.
abstract: BACKGROUND
  In areas where Mycobacterium tuberculosis is endemic, tuberculosis is known to be the most common cause of pericarditis. However, the difficulty in diagnosis may lead to late complications such as constrictive pericarditis and increased mortality. Therefore, identification of patients at a high risk for poor prognosis, and prompt initiation of treatment are important in the outcome of TB pericarditis. The aim of this study is to identify the predictive factors for unfavorable outcomes of TB pericarditis in HIV-uninfected persons in an intermediate tuberculosis burden country.
  
  
  METHODS
  A retrospective review of 87 cases of TB pericarditis diagnosed at a tertiary referral hospital in South Korea was performed. Clinical characteristics, treatment outcomes, complications during treatment, duration of treatment, and medication history were reviewed. Unfavorable outcome was defined as constrictive pericarditis identified on echocardiography performed 3 to 6 months after initial diagnosis of TB pericarditis, cardiac tamponade requiring emergency pericardiocentesis, or death. Predictive factors for unfavorable outcomes were identified.
  
  
  RESULTS
  Of the 87 patients, 44 (50.6%) had unfavorable outcomes; cardiac tamponade (n = 36), constrictive pericarditis (n = 18), and mortality (n = 4). 14 patients experienced both cardiac tamponade and constrictive pericarditis. During a 1 year out-patient clinic follow up, 4 patients required repeat pericardiocentesis and pericardiectomy was performed in 0 patients. In the multivariate analysis, patients with large amounts of pericardial effusion (P = .003), those with hypoalbuminemia (P = .011), and those without cardiovascular disease (P = .011) were found to have a higher risk of unfavorable outcomes.
  
  
  CONCLUSIONS
  HIV-uninfected patients with TB pericarditis are at a higher risk for unfavorable outcomes when presenting with low serum albumin, with large pericardial effusions, and without cardiovascular disease.
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
authors.forename: In Young
authors.initials: IY
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
authors.forename: Young Goo
authors.initials: YG
authors.lastname: Song
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
authors.forename: Moo Hyun
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
authors.forename: Woo Yong
authors.initials: WY
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
authors.forename: Je Eun
authors.initials: JE
authors.lastname: Song
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
authors.forename: Ji Un
authors.initials: JU
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea. JSJ@yuhs.ac.
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
authors.forename: Nam Su
authors.initials: NS
authors.lastname: Ku
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
authors.forename: June Myung
authors.initials: JM
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D004452:Echocardiography; D005260:Female; D015658:HIV Infections; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000472:pathogenicity; D010490:Pericardial Effusion / Q000209:etiology; D010492:Pericardiectomy; D020519:Pericardiocentesis; D010494:Pericarditis, Constrictive / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D010495:Pericarditis, Tuberculous / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D056910:Republic of Korea; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000995:Antitubercular Agents
keywords: Non-HIV; Tuberculous pericarditis; Unfavorable outcome