Tuberc Respir Dis > Volume 70(4); 2011 > Article
Tuberculosis and Respiratory Diseases 2011;70(4):323-329.
DOI:    Published online April 1, 2011.
Differences between Patients with TB-Destroyed Lung and Patients with COPD Admitted to the ICU.
Young Kyeong Seo, Chae Hun Lee, Hyun Kyung Lee, Young Min Lee, Hye Kyeong Park, Sang Bong Choi, Hyun Gook Kim, Hang Jea Jang, Ho Kee Yum, Seung Heon Lee
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University College of Medicine, Busan, Korea.
Although patients with tuberculous-destroyed lung (TDL) account for a significant proportion of those with chronic airflow obstruction, it is difficult to distinguish patients with airway obstruction due to TDL from patients with pure chronic obstructive pulmonary disease (COPD) on initial presentation with dyspnea. We investigated clinical features differing between (i) patients with TDL and airway obstruction and (ii) those with COPD admitted to the intensive care unit (ICU) due to dyspnea. METHODS: We reviewed the medical records of patients with TDL who had a forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of <70% on a pulmonary function test (PFT; best value closest to admission) and patients with COPD without a history of pulmonary tuberculosis (TB) who were admitted to the ICU. Ultimately, 16 patients with TDL and 16 with COPD were compared, excluding patients with co-morbidities. RESULTS: The mean ages of the patients with TDL and COPD were 63.7 and 71.2 years, respectively. Mean FVC% (50.4% vs. 71.9%; p<0.01) and mean FEV1% (39.1% vs. 58.4%; p<0.01) were significantly lower in the TDL group than in the COPD group. More frequent consolidation with TB (68.8% vs. 31.3%; p=0.03) and more tracheostomies (50.0% vs. 0.0%; p=0.02) were observed in the TDL than in the COPD group. CONCLUSION: Upon ICU admission, patients with TDL had TB pneumonia more frequently, more diminished PFT results, and more tracheostomies than patients with COPD.
Key Words: Tuberculosis, Pulmonary, Lung Diseases, Obstructive, Pulmonary Disease, Chronic Obstructive, Intensive Care Units

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