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首页> 外文期刊>BMC Infectious Diseases >Predictive factors for unfavorable outcomes of tuberculous pericarditis in human immunodeficiency virus–uninfected patients in an intermediate tuberculosis burden country
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Predictive factors for unfavorable outcomes of tuberculous pericarditis in human immunodeficiency virus–uninfected patients in an intermediate tuberculosis burden country

机译：中等结核病负担国家未感染人类免疫缺陷病毒的患者患结核性心包炎预后不良的预测因素

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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. Conclusion 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.
机译：背景技术在结核分枝杆菌流行的地区，已知结核病是心包炎的最常见原因。然而，诊断上的困难可能导致晚期并发症，例如缩窄性心包炎和死亡率增加。因此，在结核性心包炎的预后中，识别高危预后的高风险患者和迅速开始治疗很重要。这项研究的目的是确定结核病负担国家中未感染艾滋病毒的人结核性心包炎结局不良的预测因素。方法对韩国三级转诊医院确诊的87例结核性心包炎进行回顾性研究。回顾了临床特征，治疗结果，治疗过程中的并发症，治疗持续时间和用药史。不良结局定义为在初步诊断为TB心包炎，心包填塞需要紧急心包穿刺术或死亡后3到6个月进行超声心动图检查发现为狭窄性心包炎。确定了不利结果的预测因素。结果87例患者中有44例（50.6％）的预后不良;心脏压塞（n = 36），缩窄性心包炎（n = 18）和死亡率（n = 4）。 14例患者同时发生了心脏压塞和缩窄性心包炎。在为期1年的门诊随访中，有4例患者需要进行再次心包穿刺术，其中0例患者进行了心包切除术。在多变量分析中，发现有大量心包积液（P = ?. 003），患有低白蛋白血症的患者（P = ?. 011）和没有心血管疾病的患者（P = ?. 011）。不利的结果。结论HIV感染的结核性心包炎患者低血清白蛋白，大心包积液且无心血管疾病时，不良结局的风险较高。

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