title: Severe Tuberculosis Requiring Intensive Care: A Descriptive Analysis.
abstract: Background. This study aims to describe the characteristics of tuberculosis (TB) patients requiring intensive care and to determine the in-hospital mortality and the associated predictive factors.Methods. Retrospective cohort study of all TB patients admitted to the ICU of the Infectious Diseases Department of Centro Hospitalar de São João (Porto, Portugal) between January 2007 and July 2014. Comorbid diagnoses, clinical features, radiological and laboratory investigations, and outcomes were reviewed. Univariate analysis was performed to identify risk factors for death.Results. We included 39 patients: median age was 52.0 years and 74.4% were male. Twenty-one patients (53.8%) died during hospital stay (15 in the ICU). The diagnosis of isolated pulmonary TB, a positive smear for acid-fast-bacilli and a positive PCR forMycobacterium tuberculosisin patients of pulmonary disease, severe sepsis/septic shock, acute renal failure and Multiple Organ Dysfunction Syndrome on admission, the need for mechanical ventilation or vasopressor support, hospital acquired infection, use of adjunctive corticotherapy, smoking, and alcohol abuse were significantly associated with mortality (p< 0.05).Conclusion. This cohort of TB patients requiring intensive care presented a high mortality rate. Most risk factors for mortality were related to organ failure, but others could be attributed to delay in the diagnostic and therapeutic approach, important targets for intervention.
authors.affiliation: Infectious Diseases Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, Porto, Portugal; Instituto de Inovação e Investigação em Saúde (I3S), Grupo de I&D em Nefrologia e Doenças Infecciosas, Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal.
authors.forename: Raquel Pacheco
authors.identifier: 0000-0001-7218-8004
authors.initials: RP
authors.lastname: Duro
authors.affiliation: Infectious Diseases Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, Porto, Portugal; Instituto de Inovação e Investigação em Saúde (I3S), Grupo de I&D em Nefrologia e Doenças Infecciosas, Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Figueiredo Dias
authors.affiliation: Infectious Diseases Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, Porto, Portugal; Instituto de Inovação e Investigação em Saúde (I3S), Grupo de I&D em Nefrologia e Doenças Infecciosas, Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal.
authors.forename: Alcina Azevedo
authors.initials: AA
authors.lastname: Ferreira
authors.affiliation: Infectious Diseases Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, Porto, Portugal; Instituto de Inovação e Investigação em Saúde (I3S), Grupo de I&D em Nefrologia e Doenças Infecciosas, Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal.
authors.forename: Sandra Margarida
authors.initials: SM
authors.lastname: Xerinda
authors.affiliation: Infectious Diseases Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, Porto, Portugal; Instituto de Inovação e Investigação em Saúde (I3S), Grupo de I&D em Nefrologia e Doenças Infecciosas, Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Lima Alves
authors.affiliation: Infectious Diseases Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, Porto, Portugal; Instituto de Inovação e Investigação em Saúde (I3S), Grupo de I&D em Nefrologia e Doenças Infecciosas, Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal.
authors.forename: António Carlos
authors.initials: AC
authors.lastname: Sarmento
authors.affiliation: Infectious Diseases Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, Porto, Portugal; Instituto de Inovação e Investigação em Saúde (I3S), Grupo de I&D em Nefrologia e Doenças Infecciosas, Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal.
authors.forename: Lurdes Campos
authors.initials: LC
authors.lastname: Dos Santos