Hypoalbuminemia and Lymphocytopenia are Predictive Risk Factors for In-hospital Mortality in Patients with Tuberculosis

Abstract

Objective The aim of this study was to clarify the association between nutritional state on admission and in-hospital death in tuberculosis (TB) patients, including a high proportion of elderly patients. Methods A retrospective cohort study of 246 TB patients was conducted. The serum albumin concentrations and peripheral blood lymphocyte counts were measured on admission, and the primary outcome of interest was in-hospital death. Patient mortality was categorized into two groups: TB death and non-TB death. A multivariate analysis was performed to evaluate the relationship between nutritional state on admission and in-hospital mortality in TB patients. .015) on admission were significantly associated with all in-hospital deaths in the TB patients. The serum albumin concentrations and peripheral blood total lymphocyte counts were also found to be associated with in-hospital deaths directly caused by TB. Conclusion Hypoalbuminemia and lymphocytopenia on admission are predictive risk factors for in-hospital mortality in TB patients. Nutritional defects should thus receive special attention in order to reduce TB patient mortality, particularly among elderly patients.

High blood neutrophil-lymphocyte ratio associated with poor outcomes in miliary tuberculosis

“…Several nutritional factors are also known to be involved in poor prognosis in TB including miliary TB (1,10,11,29). Our study found no significant difference in mortality associated with BMI.…”

“…Explanation for the correlation between the increase in NLR and poor outcome has not yet been clarified. Although lymphopenia has been reported to be associated with poor prognosis in several previous analyses on TB (1,10,29), NLR has not been investigated in miliary TB. In cancer patients, some studies hypothesized that relatively low lymphocyte counts are associated with a poor response to chemotherapy in relation to cell-mediated immunity (22,30).…”

“…Our study found no significant difference in mortality associated with BMI. However, mean albumin and sodium levels were lower in non-survivors compared to those in survivors, which may be linked to nutritional status or secretory abnormalities of antidiuretic hormone (29,36).…”

Experimental Mycobacterium bovis infection in three white rhinoceroses (Ceratotherium simum): Susceptibility, clinical and anatomical pathology

“…Hypoalbuminemia has been used as a predictive risk factor for mortality in human TB patients as a reflection of nutritional status and disease chronicity [40]. Increased albumin values were observed in the experimentally infected rhinoceroses, however, albumin and total protein values increased significantly in uninfected boma adapted rhinoceroses [20], therefore these changes were probably unrelated to M .…”

Long-term outcome of polymethylmethacrylate-augmented screw fixation in the treatment of thoracolumbar spinal tuberculosis in elderly patients with severe osteoporosis

“…The accumulation of M. tuberculosis leads to poisoning symptoms affecting patients' appetite and inducing fever. Insu cient protein intake and increased metabolism due to fever can reduce serum protein levels, leading to hypoproteinemia 13 ; immunity function and compliance to systematic anti-tuberculosis treatment are really poor for elderly patients, most are complicated with huge abscess, sinus, and dead bone formation, and the value of conservative treatment is limited; tuberculosis recurrence is relatively high after the surgical intervention; in elderly patients with severe osteoporosis, multiple fractures of the thoracolumbar spine may coexist with tuberculosis. Most patients had severe kyphosis and/or neurological dysfunction when they sought medical care.…”