• K Lee, J H Kim, J H Lee, W-Y Lee, M S Park, J Y Kim, K C Kim, M-G Lee, K-S Jung, Y S Kim, Y M Shin, and Y Koh.
• Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
• Int. J. Tuberc. Lung Dis. 2011 Aug 1;15(8):1099-103.

BackgroundMiliary tuberculosis (TB) is an unusual cause of acute respiratory distress syndrome (ARDS).ObjectiveTo evaluate the clinical characteristics and outcomes of patients with ARDS caused by miliary TB admitted to the intensive care unit (ICU).DesignA total of 67 patients were enrolled during the period 1999-2008.ResultsThe median age of the patients was 56 years (range 17-81), 19 (28.4%) were aged >71 years, and 38 (56.7%) were male. All-cause mortality in the ICU and hospital were respectively 58.2% and 61.2%. Of the total number of enrolled patients, 49 (73.1%) were prescribed anti-tuberculosis medication within 3 days of hospital admission. On the day of ARDS diagnosis (10.0 ± 3.7 vs. 7.4 ± 3.5, P = 0.005), non-survivors had a significantly higher Sequential Organ Failure Assessment (SOFA) score than survivors. Multivariate analysis showed that SOFA score on the day of ARDS diagnosis was a significant predictor of survival (OR 0.809, 95%CI 0.691-0.946, P = 0.008). It was difficult to determine the efficacy of systemic corticosteroids on patient survival.ConclusionARDS caused by miliary TB was associated with a high in-hospital mortality rate, with SOFA score on the day of ARDS diagnosis being a valuable prognostic indicator.

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