Hypoalbuminemia and lymphocytopenia are predictive risk factors for in-hospital mortality in patients with tuberculosis

Kyoko Okamura, Nobuhiko Nagata, Kentaro Wakamatsu, Koji Yonemoto, Satoshi Ikegame, Akira Kajiki, Koichi Takayama, Yoichi Nakanishi

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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 concentra-tions and peripheral blood lymphocyte counts were measured on admission, and the primary outcome of in-terest 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. Results The median [interquartile range] patient age was 79 [69-83] years, and the in-hospital death rate was 20.73% (TB death: 26 patients; non-TB death: 25 patients). The multivariate analysis revealed that the serum albumin concentrations (OR: 0.21, 95% CI: 0.10-0.41; p<0.0001) and peripheral blood total lympho-cyte counts (Category 2 [627.2-1, 106.7/mm3] vs. 1 [<627.2/mm3]. OR: 0.28, 95% CI: 0.11-0.73; p=0.009, Category 3 [>1, 106.7/mm3] vs. 1. OR: 0.24, 95% CI: 0.08-0.76, p=0.015) on admission were significantly as-sociated 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 pa-tient mortality, particularly among elderly patients.

Original languageEnglish
Pages (from-to)439-444
Number of pages6
JournalInternal Medicine
Volume52
Issue number4
DOIs
Publication statusPublished - Feb 21 2013

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Hypoalbuminemia
Lymphopenia
Hospital Mortality
Tuberculosis
Serum Albumin
Lymphocyte Count
Mortality
Multivariate Analysis
Cohort Studies
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Okamura, K., Nagata, N., Wakamatsu, K., Yonemoto, K., Ikegame, S., Kajiki, A., ... Nakanishi, Y. (2013). Hypoalbuminemia and lymphocytopenia are predictive risk factors for in-hospital mortality in patients with tuberculosis. Internal Medicine, 52(4), 439-444. https://doi.org/10.2169/internalmedicine.52.8158

Hypoalbuminemia and lymphocytopenia are predictive risk factors for in-hospital mortality in patients with tuberculosis. / Okamura, Kyoko; Nagata, Nobuhiko; Wakamatsu, Kentaro; Yonemoto, Koji; Ikegame, Satoshi; Kajiki, Akira; Takayama, Koichi; Nakanishi, Yoichi.

In: Internal Medicine, Vol. 52, No. 4, 21.02.2013, p. 439-444.

Research output: Contribution to journalArticle

Okamura, K, Nagata, N, Wakamatsu, K, Yonemoto, K, Ikegame, S, Kajiki, A, Takayama, K & Nakanishi, Y 2013, 'Hypoalbuminemia and lymphocytopenia are predictive risk factors for in-hospital mortality in patients with tuberculosis', Internal Medicine, vol. 52, no. 4, pp. 439-444. https://doi.org/10.2169/internalmedicine.52.8158
Okamura, Kyoko ; Nagata, Nobuhiko ; Wakamatsu, Kentaro ; Yonemoto, Koji ; Ikegame, Satoshi ; Kajiki, Akira ; Takayama, Koichi ; Nakanishi, Yoichi. / Hypoalbuminemia and lymphocytopenia are predictive risk factors for in-hospital mortality in patients with tuberculosis. In: Internal Medicine. 2013 ; Vol. 52, No. 4. pp. 439-444.
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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 concentra-tions and peripheral blood lymphocyte counts were measured on admission, and the primary outcome of in-terest 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. Results The median [interquartile range] patient age was 79 [69-83] years, and the in-hospital death rate was 20.73{\%} (TB death: 26 patients; non-TB death: 25 patients). The multivariate analysis revealed that the serum albumin concentrations (OR: 0.21, 95{\%} CI: 0.10-0.41; p<0.0001) and peripheral blood total lympho-cyte counts (Category 2 [627.2-1, 106.7/mm3] vs. 1 [<627.2/mm3]. OR: 0.28, 95{\%} CI: 0.11-0.73; p=0.009, Category 3 [>1, 106.7/mm3] vs. 1. OR: 0.24, 95{\%} CI: 0.08-0.76, p=0.015) on admission were significantly as-sociated 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 pa-tient mortality, particularly among elderly patients.",
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AU - Okamura, Kyoko

AU - Nagata, Nobuhiko

AU - Wakamatsu, Kentaro

AU - Yonemoto, Koji

AU - Ikegame, Satoshi

AU - Kajiki, Akira

AU - Takayama, Koichi

AU - Nakanishi, Yoichi

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N2 - 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 concentra-tions and peripheral blood lymphocyte counts were measured on admission, and the primary outcome of in-terest 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. Results The median [interquartile range] patient age was 79 [69-83] years, and the in-hospital death rate was 20.73% (TB death: 26 patients; non-TB death: 25 patients). The multivariate analysis revealed that the serum albumin concentrations (OR: 0.21, 95% CI: 0.10-0.41; p<0.0001) and peripheral blood total lympho-cyte counts (Category 2 [627.2-1, 106.7/mm3] vs. 1 [<627.2/mm3]. OR: 0.28, 95% CI: 0.11-0.73; p=0.009, Category 3 [>1, 106.7/mm3] vs. 1. OR: 0.24, 95% CI: 0.08-0.76, p=0.015) on admission were significantly as-sociated 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 pa-tient mortality, particularly among elderly patients.

AB - 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 concentra-tions and peripheral blood lymphocyte counts were measured on admission, and the primary outcome of in-terest 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. Results The median [interquartile range] patient age was 79 [69-83] years, and the in-hospital death rate was 20.73% (TB death: 26 patients; non-TB death: 25 patients). The multivariate analysis revealed that the serum albumin concentrations (OR: 0.21, 95% CI: 0.10-0.41; p<0.0001) and peripheral blood total lympho-cyte counts (Category 2 [627.2-1, 106.7/mm3] vs. 1 [<627.2/mm3]. OR: 0.28, 95% CI: 0.11-0.73; p=0.009, Category 3 [>1, 106.7/mm3] vs. 1. OR: 0.24, 95% CI: 0.08-0.76, p=0.015) on admission were significantly as-sociated 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 pa-tient mortality, particularly among elderly patients.

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