{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:00:00Z","timestamp":1780977600616,"version":"3.54.1"},"reference-count":34,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>High mortality rates are commonly found in critically ill patients with tuberculosis (TB), which is due partially to limitations in the existing prognostic evaluation methods. Therefore, we aimed to find more effective prognostic evaluation tools to reduce the mortality rate. Data from critically ill patients with TB admitted to the intensive care unit of The Second Hospital of Nanjing, Nanjing, China, between January 2020 and December 2022 were analyzed retrospectively. A total of 115 patients were enrolled and divided into a survival group (<jats:italic>n<\/jats:italic> = 62) and a death group (<jats:italic>n<\/jats:italic> = 53) according to 30-day survival. Univariate and least absolute shrinkage and selection operator (LASSO) regression analyses were used to investigate the risk factors for 30-day death in critically ill patients with TB. A prediction model for risk of 30-day mortality was developed for critically ill patients with TB in the intensive care unit. The LASSO regression model showed that the prognostic nutritional index (PNI) and Acute Physiology and Chronic Health Status (APACHE II) scores on the third day after admission to the intensive care unit were independent risk factors for 30-day mortality in critically ill patients with TB (<jats:italic>P<\/jats:italic> &lt;0.05). The area under the curve value and that PA3 represents the combination of the PNI and APACHE II score on the third day, which was 0.952 (95% CI: 0.913\u20130.991, <jats:italic>P<\/jats:italic> &lt;0.001), was significantly higher than that of the PNI or the APACHE II score on the third day. The new model is as follows: PA3 = APACHE II score (on the third day) \u00d7 0.421 \u2013 PNI \u00d7 0.204. The PNI combined with the APACHE II score on the third day could well predict the 30-day mortality risk of critically ill patients with TB.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0661","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T13:32:11Z","timestamp":1726666331000},"page":"1027-1033","source":"Crossref","is-referenced-by-count":2,"title":["Predictive Mortality of the Prognostic Nutritional Index Combined with APACHE II Score for Critically Ill Tuberculosis Patients"],"prefix":"10.4269","volume":"111","author":[{"given":"Qi","family":"Yuan","sequence":"first","affiliation":[{"name":"Department of Intensive Care Unit, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yishan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Clin Pharmacol Ther","first-page":"1455","article-title":"The treatment of tuberculosis","volume":"110","author":"Peloquin","year":"2021"},{"key":"b2","series-title":"Exp Ther Med","first-page":"2719","article-title":"Inflammation responses in patients with pulmonary tuberculosis in an intensive care unit","volume":"15","author":"Liu","year":"2018"},{"key":"b3","series-title":"Pulmonology","first-page":"297","article-title":"Pulmonary tuberculosis in intensive care setting, with a focus on the use of severity scores, a multinational collaborative systematic review","volume":"28","author":"Galvin","year":"2022"},{"key":"b4","series-title":"J Chin Med Assoc","first-page":"605","article-title":"Contributing factors to mortality rates of pulmonary tuberculosis in intensive care units","volume":"81","author":"Tatar","year":"2018"},{"key":"b5","series-title":"Int J Tuberc Lung Dis","first-page":"335","article-title":"Predictive factors for mortality among non-HIV-infected patients with pulmonary tuberculosis and respiratory failure","volume":"13","author":"Lin","year":"2009"},{"key":"b6","series-title":"BMC Infect Dis","first-page":"54","article-title":"Mortality among patients with tuberculosis requiring intensive care: A retrospective cohort study","volume":"10","author":"Silva","year":"2010"},{"key":"b7","series-title":"Intensive Care Med","first-page":"223","article-title":"ICU scoring systems","volume":"49","author":"Quintairos","year":"2023"},{"key":"b8","series-title":"Yonsei Med J","first-page":"425","article-title":"External validation of the Acute Physiology and Chronic Health Evaluation II in Korean intensive care units","volume":"54","author":"Kim","year":"2013"},{"key":"b9","series-title":"Front Med (Lausanne)","first-page":"744907","article-title":"Dynamic APACHE II score to predict the outcome of intensive care unit patients","volume":"8","author":"Tian","year":"2021"},{"key":"b10","series-title":"PLoS One","first-page":"e0195628","article-title":"Serial evaluation of SOFA and APACHE II scores to predict neurologic outcomes of out-of-hospital cardiac arrest survivors with targeted temperature management","volume":"13","author":"Yoon","year":"2018"},{"key":"b11","series-title":"Resuscitation","first-page":"651","article-title":"APACHE II scoring to predict outcome in post-cardiac arrest","volume":"84","author":"Donnino","year":"2013"},{"key":"b12","series-title":"J Crit Care","first-page":"184","article-title":"The critically ill patient with tuberculosis in intensive care: Clinical presentations, management and infection control","volume":"45","author":"Otu","year":"2018"},{"key":"b13","series-title":"Front Nutr","first-page":"1073782","article-title":"Importance of nutritional assessment tools in the critically ill patient: A systematic review","volume":"9","author":"Domenech-Briz","year":"2022"},{"key":"b14","series-title":"Front Vet Sci","first-page":"69","article-title":"A comparative review of equine SIRS, sepsis, and neutrophils","volume":"6","author":"Sheats","year":"2019"},{"key":"b15","series-title":"Front Public Health","first-page":"1039661","article-title":"Prevalence and prognostic significance of malnutrition risk in patients with pulmonary tuberculosis: A hospital-based cohort study","volume":"10","author":"Ma","year":"2022"},{"key":"b16","series-title":"WS 196-2017 Diagnosis for Pulmonary Tuberculosis","year":"2017"},{"key":"b17","series-title":"Zhonghua Xue Ye Xue Za Zhi","first-page":"52","article-title":"Study of clinical outcome and prognosis in pediatric core binding factor-acute myeloid leukemia","volume":"40","author":"Wu","year":"2019"},{"key":"b18","series-title":"BMC Infect Dis","first-page":"5","article-title":"Tuberculosis mortality: Patient characteristics and causes","volume":"14","author":"Lin","year":"2014"},{"key":"b19","series-title":"Anaesthesia","first-page":"937","article-title":"APACHE II, data accuracy and outcome prediction","volume":"53","author":"Goldhill","year":"1998"},{"key":"b20","series-title":"Anesth Analg","first-page":"1693","article-title":"Systemic inflammatory response syndrome after surgery: Mechanisms and protection","volume":"131","author":"Margraf","year":"2020"},{"key":"b21","series-title":"Best Pract Res Clin Anaesthesiol","first-page":"113","article-title":"Inflammatory response and extracorporeal circulation","volume":"29","author":"Kraft","year":"2015"},{"key":"b22","series-title":"Clin Transl Med","first-page":"e1163","article-title":"Therapeutic potential of mesenchymal stromal\/stem cells in critical-care patients with systemic inflammatory response syndrome","volume":"13","author":"Mart\u00ed-Chill\u00f3n","year":"2023"},{"key":"b23","series-title":"Eur Respir J","first-page":"2201596","article-title":"Global estimates and determinants of antituberculosis drug pharmacokinetics in children and adolescents: A systematic review and individual patient data meta-analysis","volume":"61","author":"Gafar","year":"2023"},{"key":"b24","series-title":"Lancet","first-page":"1927","article-title":"Management of disease-related malnutrition for patients being treated in hospital","volume":"398","author":"Schuetz","year":"2021"},{"key":"b25","series-title":"Int J Tuberc Lung Dis","first-page":"54","article-title":"Development and validation of a tuberculosis prognostic score for smear-positive in-patients in Japan","volume":"17","author":"Horita","year":"2013"},{"key":"b26","series-title":"BMC Infect Dis","first-page":"251","article-title":"Development and validation of a prognostic score during tuberculosis treatment","volume":"17","author":"Pefura-Yone","year":"2017"},{"key":"b27","series-title":"Crit Care Med","first-page":"367","article-title":"Enteral nutrition in the critically ill patient: Role of hypoalbuminemia","volume":"17","author":"Brinson","year":"1989"},{"key":"b28","series-title":"Sci Rep","first-page":"24379","article-title":"Effect of hypoproteinemia on the mortality of sepsis patients in the ICU: A retrospective cohort study","volume":"11","author":"Hu","year":"2021"},{"key":"b29","series-title":"Cochrane Database Syst Rev","first-page":"Cd001208","article-title":"Human albumin solution for resuscitation and volume expansion in critically ill patients","volume":"2011","author":"Roberts","year":"2011"},{"key":"b30","series-title":"Sci Rep","first-page":"10308","article-title":"Elevated transaminases and hypoalbuminemia in Covid-19 are prognostic factors for disease severity","volume":"11","author":"Wagner","year":"2021"},{"key":"b31","series-title":"Infect Drug Resist","first-page":"6039","article-title":"Albumin infusion may improve the prognosis of critical COVID-19 patients with hypoalbuminemia in the intensive care unit: A retrospective cohort study","volume":"15","author":"Zhang","year":"2022"},{"key":"b32","series-title":"JPEN J Parenter Enteral Nutr","first-page":"181","article-title":"Hypoalbuminemia: Pathogenesis and clinical significance","volume":"43","author":"Soeters","year":"2019"},{"key":"b33","series-title":"Cell Rep","first-page":"109696","article-title":"CD4 T cell help prevents CD8 T cell exhaustion and promotes control of Mycobacterium tuberculosis infection","volume":"36","author":"Lu","year":"2021"},{"key":"b34","series-title":"Cell Mol Life Sci","first-page":"1859","article-title":"Host defense mechanisms against Mycobacterium tuberculosis.","volume":"77","author":"Chai","year":"2020"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/111\/5\/article-p1027.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/111\/5\/article-p1027.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/111\/5\/article-p1027.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T13:45:35Z","timestamp":1730900735000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/111\/5\/article-p1027.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,6]]},"references-count":34,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.23-0661","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,6]]}}}