Situación nutricional y mortalidad en pacientes con diagnóstico de tuberculosis activa

Karen Juliana Moreno Soto; Isabella Montaño Rivas; Luis Gabriel Parra Lara; Robinson Pacheco; José Fernando García Goez

doi:10.30789/rcneumologia.v31.n1.2019.327

Nutritional status and mortality in patients diagnosed with active tuberculosis

Situación nutricional y mortalidad en pacientes con diagnóstico de tuberculosis activa

Published 2019-08-15

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Vol. 31 No. 1 (2019)

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Research article

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Nutritional status and mortality in patients diagnosed with active tuberculosis. rev. colomb. neumol. [Internet]. 2019 Aug. 15 [cited 2024 Nov. 15];31(1). Available from: https://revistas.asoneumocito.org/index.php/rcneumologia/article/view/327

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https://doi.org/10.30789/rcneumologia.v31.n1.2019.327

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Karen Juliana Moreno Soto

Isabella Montaño Rivas

Luis Gabriel Parra Lara

Robinson Pacheco

José Fernando García Goez

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Mycobacterium tuberculosis

nutritional status

body mass index

serum albumin

mortality

INTRODUCTION: Tuberculosis (TBC) continues to be a global public health problem. Despite advances in treatment, it has been shown that patient’s nutritional status influences the prognosis and results of treatment. The objective of this study was to describe the nutri- tional status, diagnosis and results of treatment in patients with TBC.

MATERIALS AND METHODS: Historic cohort study. We analyzed adult patients older than 18 years with TBC and weight and height record at the time of diagnosis between Fe- bruary 2007 to May 2017 at Fundación Valle del Lili (FVL) in Cali, Colombia.

RESULTS AND DISCUSSION: A total of 388 patients were included, 52% (n=200) had normal weight and 23% (n=88) had low weight. The most frequent comorbidities were human immunodeficiency virus (HIV) in 14% (n=56) and diabetes mellitus in 13% (n=52). There was no statistically significant association between body mass index (BMI) and albumin level (p: 0.387, Odds ratio [OR]: 1.29; confidence interval [CI] 95%: 0.73-2.28). An overall mortality of 9% was found (n=35). BMI <18.5 was not associated with mortality (p=0.65, OR: 0.81, CI 95%: 0.32-2.07). In more than 50% of the patients, hypoalbuminemia was documented at the time of diagnosis, which was associated with mortality (p <0.001, OR: 6.23, CI 95%: 3.7-70.6).

CONCLUSIONS: Knowing accurately the nutritional status of the patient with TBC could help to create strategies that allow to improve the prognosis and the results to treatment. BMI does not always reflect the actual nutritional status of the patient. The serum albumin level <3.5 g/dL is a predictive marker of mortality in patients with active TBC disease.

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World Health Organization. Global tuberculosis report 2017. Génova: WHO; 2017.
López Pérez MP. Informe del evento. Tuberculosis, Colom- bia, 2017. Instituto Nacional de Salud [internet] 2018 [acceso el 20 de abril de 2018]. Disponible en: https://www.ins.gov. co/buscador-eventos/Informesdeevento/Tuberculosis%20 2017.pdf.
Instituto Nacional de Salud, Ministerio de Salud y Protección Social. Protocolo de Vigilancia en Salud Pública: Tuberculo- sis. Bogotá D. C.: Instituto Nacional de Salud; 2016.
Kant S, Gupta H, Ahluwalia S. Significance of nutri- tion in pulmonary tuberculosis. Crit Rev Food Sci Nutr. 2015;55(7):955–63.
Choi R, Jeong B-H, Koh W-J, Lee S-Y. Recommendations for Optimizing Tuberculosis Treatment: Therapeutic Drug Moni- toring, Pharmacogenetics, and Nutritional Status Consider- ations. Ann Lab Med. 2017;37(2):97-107.
Karyadi E, Schultink W, Nelwan RH, Gross R, Amin Z, Dolmans WM, et al. Poor micronutrient status of active pulmonary tuber- culosis patients in Indonesia. J Nutr. 2000;130(12):2953-8.
Okamura K, Nagata N, Wakamatsu K, Yonemoto K, Ikegame S, Kajiki A, et al. Hypoalbuminemia and Lymphocytopenia are Predictive Risk Factors for In-hospital Mortality in Pa- tients with Tuberculosis. Intern Med. 2013;52(4):439-44.
Martínez Gutiérrez AC, Chávez Vivas M. Caracterización clínica y terapéutica de pacientes con tuberculosis pulmonar en Cali Caracterização em Cali Clinical and therapeutic of pa- tients with pulmonary tuberculosis in Cali. Av en Enfermería. 2017;35(3):324-32.
Congreso de la República de Colombia. Ley 100 de 1993 [Internet]. Colombia: Senado de la República de Colombia; 1993.
World Health Organization. Definiciones y marco de trabajo para la notificación de tuberculosis-revisión 2013. WHO [In- ternet] 2013. Disponible en: http://www.paho.org/hq/index. php?option=com_docman&task=doc_download&gid=22984 &Itemid=270&lang=es.
World Health Organization. Body mass index - BMI. WHO [Internet] 2018 [acceso el 6 de septiembre de 2018]. Disponible en: http://www.euro.who.int/en/health-topics/disease-preven- tion/nutrition/a-healthy-lifestyle/body-mass-index-bmi.
Akirov A, Masri-Iraqi H, Atamna A, Shimon I. Low Albumin Levels Are Associated with Mortality Risk in Hospitalized Patients. Am J Med. 2017;130(12):1465.e11-1465.e19.
World Health Organization. Concentraciones de hemo- globina para diagnosticar la anemia y evaluar su gravedad. WHO [Internet] 2011. Disponible en: https://apps.who.int/
iris/bitstream/handle/10665/85842/WHO_NMH_NHD_
MNM_11.1_spa.pdf?sequence=7&isAllowed=y.
Sánchez-Valle ME, Hernández Navarro F. Protocolo diag- nóstico de la linfopenia. Med - Programa Form Médica Con- tin Acreditado. 2004;9(21):1362-4.
Green RM, Flamm S. AGA Technical Review on the Evaluation of Liver Chemestry Test. Gastroenterology. 2002;123(4):1367-84.
Kwo PY, Cohen SM, Lim JK. ACG Clinical Guideline: Eva- luation of Abnormal Liver Chemistries. Am J Gastroenterol. 2017;112(1):18-35.
Strasser M, Singh D. Interpretation of Abnormal Liver
Function Tests. Hosp Med Clin. 2014;3(1):e139-48.
Cui J, Xiong J, Zhang Y, Peng T, Huang M, Lin Y, et al. Serum lactate dehydrogenase is predictive of persistent organ failure in acute pancreatitis. J Crit Care. 2017;41:161-5.
Liu Y, Zheng Y, Chen J, Shi Y, Shan L-Y, Wang S, et al. Tu- berculosis-associated mortality and its risk factors in a district of Shanghai, China: a retrospective cohort study. Int J Tuberc Lung Dis. 2018;22(6):655-60.
Cañas Castillo KG, Imtyaz Ahmad M, Navas T. Tuberculosis: características epidemiológicas en un hospital tipo IV. Med interna. 2015;31(1):31-43.
Hanrahan CF, Golub JE, Mohapi L, Tshabangu N, Modisen- yane T, Chaisson RE, et al. Body mass index and risk of tuber- culosis and death. AIDS. 2010;24(10):1501-8.
Roth J. Evolutionary speculation about tuberculosis and the metabolic and inflammatory processes of obesity. JAMA. 2009;301(24):2586-8.
Matos ED, Moreira Lemos AC. Association between serum albumin levels and in-hospital deaths due to tuberculosis. Int J Tuberc Lung Dis. 2006;10(12):1360-6.
Oliveira MG, Delogo KN, Oliveira HM, Ruffino-Netto A, Kritski AL, Oliveira MM. Anemia in hospitalized patients with pulmonary tuberculosis. J Bras Pneumol. 2014;40(4):403-10.
Zachariah R, Spielmann MP, Harries AD, Salaniponi FML. Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early death. Trans R Soc Trop Med Hyg. 2000;96(3):291-4.
Bhargava A, Chatterjee M, Jain Y, Chatterjee B, Kataria A, Bhargava M, et al. Nutritional Status of Adult Patients with Pulmonary Tuberculosis in Rural Central India and Its Association with Mortality. Noymer A, editor. PLoS One. 2013;8(10):e77979.
Odone A, Houben RM, White RG, Lönnroth K. The effect of diabetes and undernutrition trends on reaching 2035 global tuberculosis targets. Lancet Diabetes Endocrinol. 2014;2(9):754-64.