564. Predictive Factors for Unfavorable Outcomes of Tuberculous Pericarditis in Human Immunodeficiency Virus–Uninfected Patients in an Intermediate Tuberculosis Burden Country
Session: Poster Abstract Session: Tuberculosis Treatment and Outcome
Thursday, October 27, 2016
Room: Poster Hall

Background: 

In areas where Mycobacterium tuberculosis is endemic, tuberculosis is known to be the most common cause of pericarditis. Although there are many reports on tuberculous (TB) pericarditis in HIV-infected persons, no large-scale prospective study on the treatment outcomes of HIV-uninfected patients with TB pericarditis has been reported. This is the first study to identify the predictive factors for unfavorable outcomes of TB pericarditis in HIV-uninfected persons in an intermediate tuberculosis burden country.

Methods: 

A systematic review of 87 cases of TB pericarditis diagnosed at a tertiary referral hospital in South Korea during an 11-year period was performed. Clinical characteristics, treatment outcomes, complications during treatment, duration of treatment, and medication history were reviewed. Predictive factors for unfavorable outcomes were identified.

Results: 

Of the 87 patients, 44 (50.6%) had unfavorable outcomes, with mortality in 4 patients. In the multivariate analysis, patients with large amounts of pericardial effusion (P = .003), those with hypoalbuminemia (P = .011), and those without cardiovascular disease (P = .011) were found to have a higher risk of unfavorable outcomes.

Conclusion: 

HIV-uninfected patients with TB pericarditis are at a higher risk for unfavorable outcomes when presenting with low serum albumin, with large pericardial effusions, and without cardiovascular disease.

Table. Multivariate Analysis of Predictive Factors for Unfavorable Outcomes in Patients with Tuberculous Pericarditis

Variables

OR (95% CI)

P-value

Large PE

5.974 (1.811-19.703)

.003

Cardiovascular disease

0.255 (0.089-0.733)

.011

Hypoalbuminemia*

4.905 (1.443-16.667)

.011

Dyspnea

2.792 (0.852-9.145)

.090

Male

2.063 (0.745-5.713)

.163

* defined as serum albumin concentration below 3.0g/dL

OR, odds ratio; CI, confidence interval; PE, pericardial effusion.

In Young Jung, MD1, Young Goo Song, MD, PhD1, Jun Yong Choi, MD, PhD1, Moo Hyun Kim, MD2, Woo Yong Jeong, MD2, Dong Hyun Oh, MD1, Yong Chan Kim, MD1, Je Eun Song, MD1, Eun Jin Kim, MD2, Ji Un Lee, M.D.3, Su Jin Jeong, MD/PhD1, Nam Su Ku, MD1 and June Myung Kim, MD, PhD1, (1)Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea, (2)Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea, The Republic of, (3)Division of Infecious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea

Disclosures:

I. Y. Jung, None

Y. G. Song, None

J. Y. Choi, None

M. H. Kim, None

W. Y. Jeong, None

D. H. Oh, None

Y. C. Kim, None

J. E. Song, None

E. J. Kim, None

J. U. Lee, None

S. J. Jeong, None

N. S. Ku, None

J. M. Kim, None

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