Gayathri, S Rajeev (2020) Prevalence and Risk Factors for Pulmonary ArteryHypertension and Corpulmonale in Post Tuberculosis Pulmonary Sequelae. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
INTRODUCTION: Patients treated with pulmonary tuberculosis are frequently left with sequelae. The resulting parenchymal impairment can cause pulmonary hypertension. But tuberculosis sequelae as a cause of pulmonary hypertension have not been evaluated and remain an unmeasured burden due to tuberculosis. In India, with high TB burden, prevalence might be high and it needs to be studied. AIM OF THE STUDY: To assess the prevalence and risk factors for pulmonary hypertension in post pulmonary tuberculosis sequelae MATERIALS AND METHODS: It is a cross sectional study conducted in Tirunelveli Medical College from January 2018 to June 2019. Patients with history of pulmonary tuberculosis and sequelae in chest X-ray were included. Data were collected for risk factors, like age, sex, BMI, smoking history, diabetes, previous pulmonary tuberculosis episodes, extension and type of sequelae in chest X-Ray and spirometry pattern. Transthoracic echocardiography was done. Statistical analysis was done. RESULTS: 100 patients with sequelae were assessed. 44 of them had pulmonary hypertension, out of which 31 (70.5%) had cor pulmonale. While assessing risk factors, male gender (p=0.03), underweight (p<0.001) and smoking (p=0.03) had significant risk. In history of pulmonary tuberculosis, only treatment defaulted patients had significant risk with p=0.02 and odds ratio 2.56. Number of zones (p<0.001) and laterality of disease (p<0.001) in chest X-Ray showed significant relationship, with odds ratio for ≥3 zones 14.88 and bilateral disease 6.49. Most common lesion was fibrosis (82%). Patients with multiple type of lesion, had more risk than with single type of lesion (p<0.001). Patients with mixed pattern in spirometry had significant risk (p<0.001) than patients with either one pattern. On assessing risk factors for cor pulmonale, severity of pulmonary hypertension (p<0.001), smoking and extensive involvement in chest X-ray had significant risk. CONCLUSION: Pulmonary hypertension is a significant complication in post pulmonary tuberculosis sequelae patients. Smoking, defaulting treatment and extensive lesions had higher risk. This emphasizes the need for early detection, treatment with adequate regimen and ensuring compliance with treatment of pulmonary tuberculosis and the need for formulating recommendations regarding long term follow up of treated tuberculosis patients to prevent morbidity and mortality associated with pulmonary hypertension.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201727201 |
| Uncontrolled Keywords: | Post pulmonary tuberculosis sequelae, pulmonary artery hypertension, cor pulmonale, prevalence, risk factors. |
| Subjects: | MEDICAL > Tuberculosis and Respiratory Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 04 Feb 2021 16:25 |
| Last Modified: | 04 Feb 2021 16:25 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13812 |
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