J Korean Med Sci.  2009 Apr;24(2):237-241. 10.3346/jkms.2009.24.2.237.

Prevalence and Its Predictors of Extrapulmonary Involvement in Patients with Pulmonary Tuberculosis

• Kim MJ
• Kim HR
• Hwang SS
• Kim YW
• Han SK
• Shim YS
• Yim JJ

• KMID: 1779124
• DOI: http://doi.org/10.3346/jkms.2009.24.2.237

Abstract

Extrapulmonary organ involvement in human immunodefiaency virus (HIV)-infected patients with pulmonary tuberculosis (TB) is reported to be 26%, however, the clinical predictors of extrapulmonary involvement in pulmonary TB patients has not been reported yet. We tried to determine the clinical predictors of presence of extrapulmonary involvement in patients with pulmonary TB. Cross-sectional study was performed including all adult patients with culture-proven pulmonary TB diagnosed between January 1, 2004 and July 30, 2006, at a tertiary referral hospital in South Korea. The presence of extra-pulmonary TB involvement was diagnosed based on bacteriological, pathological, or clinical evidence. Among 320 patients with a culture-proven pulmonary TB, 40 had extrapulmonary involvement. Patients with bilateral lung involvement were more likely to have extrapulmonary involvement, with an adjusted odds ratio (OR) of 4.21 (95% confidence interval [CI], 1.82-9.72), while patients older than 60 yr (adjusted OR, 0.27; 95% CI, 0.08-0.89), patients with cavitary lesions (adjusted OR, 0.37; 95% CI, 0.16-0.84), and with higher levels of serum albumin (adjusted OR, 0.45; 95% CI, 0.25-0.78) had less frequent involvement. Clinicians should be aware of the possibility of extrapulmonary involvement in TB patients with bilateral lung involvement without cavity formation or lower levels of serum albumin.

Keyword

Tuberculosis; Tuberculosis, Miliary; Diagnosis

MeSH Terms

Adult
Aged
Cross-Sectional Studies
Female
Humans
Male
Medical Records
Middle Aged
Odds Ratio
Predictive Value of Tests
Prevalence
Regression Analysis
Retrospective Studies
Serum Albumin/analysis
Tuberculosis, Pulmonary/*diagnosis/epidemiology/radiography

Figure

• 

  Fig. 1 Classification and regression trees (CART) analysis for predicting combined extra-pulmonary involvement in patients with pulmonary TB EPTB, pulmonary TB with extra-pulmonary involvement; sAlbumin, serum level of albumin.

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