APACHE-II score for anti-tuberculosis tolerance in critically ill patients: a retrospective study

Junke Qiu, Caihong Wang, Xiaohong Pan, Lei Pan, Xiaoqing Huang, Jiekun Xu, Xiaobo Ji, Minjie Mao
2019 BMC Infectious Diseases  
To investigate the status of anti-tuberculosis treatment in critically ill patients, and to explore the value of APACHE-II score in guiding anti-tuberculosis treatment. Methods: This analysis included critically ill patients with tuberculosis. The utility of APACHE-II score for predicting drug withdrawal was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Among 320 patients enrolled (58 ± 22 years; 256 males), 147 (45.9%) had drugs withdrawn. The drug withdrawal
more » ... The drug withdrawal group had higher APACHE-II score (median [interquartile range]: 21 vs. 17 [4-42] points), higher CD4%, lower hemoglobin level, higher rates of chronic obstructive pulmonary disease (COPD) and chronic renal failure, and lower rate of extrapulmonary tuberculosis (P < 0.05). Logistic regression identified APACHE-II score > 18 (odds ratio [95% confidence interval]: 2.099 [1.321-3.334], P < 0.01), COPD (1.913 [1.028-3.561], P < 0.05) and hemoglobin level (0.987 [0.977-0.997], P < 0.05) as independent factors associated with drug withdrawal. At an optimal cutoff of 18.5, the sensitivity, specificity, positive predictive value and negative predictive value of APACHE-II score for predicting drug withdrawal was 59.2, 61.8, 56.9 and 64.1%, respectively. Conclusions: APACHE-II score > 18 points might predict patient tolerance of anti-tuberculosis treatment.
doi:10.1186/s12879-019-3751-7 fatcat:zdyyvcnvyjamvpnn7tmcex3dti