• Thomas Isaiah Sudarsan, Lovely Thomas, Abhishek Samprathi, Binila Chacko, Alice Mathuram, Tina George, Gunasekaran Karthik, Sudha Jasmine Rajan, Ronald Albert Benton Carey, Gowri Mahasampath, and John Victor Peter.
• Medical Intensive Care Unit (MICU), Christian Medical College (CMC), Vellore, India.
• J Crit Care. 2021 Feb 1; 61: 138-143.

BackgroundPatients with tuberculosis (TB) developing acute respiratory distress syndrome (ARDS) may have a higher mortality when compared with ARDS of other infectious etiology.MethodologyIn this single-centre retrospective cohort study spanning 5-years (2012 to 2016), TB-ARDS patients were age and gender matched (1:2) with non-TB infectious ARDS and followed up until death or hospital discharge. Clinical profile, treatment and outcomes were compared using t-test and Chi-square as appropriate. Mortality predictors were explored using Conditional Poisson regression analysis and expressed as relative risk (RR) with 95% confidence interval (CI).ResultsOf the 516 ARDS patients, 74 TB-ARDS and 148 non-TB infectious ARDS patients were included. Although admission APACHE-II (21.4 ± 7.1 vs. 17.6 ± 6.8, p < 0.001), incidence of shock (36.5% vs. 19.1%, p = 0.005) and mortality (59.5% vs. 29.7%, p < 0.001) were significantly higher in TB-ARDS than non-TB etiology, overall ICU length of stay and nosocomial infections were similar in both groups. On regression analysis, after adjusting for confounders, TB-ARDS (RR 1.82; 95% CI 1.13-2.92) and need for inotropes (RR 3.49; 95% CI 1.44-8.46) were independently associated with death.ConclusionPatients with TB-ARDS presented sicker and had higher mortality when compared with ARDS due to non-TB infectious etiology.Copyright © 2020 Elsevier Inc. All rights reserved.

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