Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil.

Autor: Dos Santos DT; Ribeirão Preto College of Nursing (EERP/USP), University of São Paulo, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil., Arroyo LH; Ribeirão Preto College of Nursing (EERP/USP), University of São Paulo, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil., Alves YM; Postgraduate in the Public Health Nursing Program, Ribeirão Preto College of Nursing at University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Alves LS; Postgraduate in the Public Health Nursing Program, Ribeirão Preto College of Nursing at University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Berra TZ; Postgraduate in the Public Health Nursing Program, Ribeirão Preto College of Nursing at University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Crispim JA; Inter-institucional Doctoral Program in Nursing, Ribeirão Preto College of Nursing at University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Alves JD; Nursing Department, Federal University of Mato Grosso, Barra do Garças, Cuiabá, Brazil., Ramos DAC; Facultad de Enfermería, Universidade Andrés Bello, Santiago, Chile., Alonso JB; Ribeirão Preto College of Nursing (EERP/USP), University of São Paulo, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil., de Assis IS; University Center Dinâmica of Cataratas (UDC), Foz do Iguazu, Paraná, Brazil., Ramos AV; Postgraduate in the Public Health Nursing Program, Ribeirão Preto College of Nursing at University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Dessunti EM; State University of Londrina, Londrina, Brazil., Carvalho Pinto I; Postgraduate in the Public Health Nursing Program, Ribeirão Preto College of Nursing at University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Palha PF; Postgraduate in the Public Health Nursing Program, Ribeirão Preto College of Nursing at University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Arcêncio RA; Ribeirão Preto College of Nursing (EERP/USP), University of São Paulo, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil. ricardo@eerp.usp.br., Nunes C; NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal.
Jazyk: angličtina
Zdroj: Tropical medicine and health [Trop Med Health] 2021 Apr 21; Vol. 49 (1), pp. 31. Date of Electronic Publication: 2021 Apr 21.
DOI: 10.1186/s41182-021-00320-4
Abstrakt: Background: A diagnosis of tuberculosis (TB) does not mean that the disease will be treated successfully, since death may occur even among those who are known to the health services. Here, we aimed to analyze patient survival time from the diagnosis of TB to death, precocious deaths, and associated factors in southern Brazil.
Methods: We conducted a longitudinal study with patients who were diagnosed with TB and who died due to the disease between 2008 and 2015 in southern Brazil. The starting point for measuring survival time was the patient's diagnosis date. Techniques for survival analysis were employed, including the Kaplan-Meier test and Cox's regression. A mixed-effect model was applied for identifying the associated factors to precocious deaths. Hazard ratio (HR) and odds ratio (OR) with 95% confidence intervals (95% CI) were estimated. We defined p value <0.05 as statistically significant for all statistics applied.
Results: One hundred forty-six patients were included in the survival analysis, observing a median survival time of 23.5 days. We observed that alcoholism (HR=1.55, 95% CI=1.04-2.30) and being male (HR=6.49, 95% CI=1.03-2.68) were associated with death. The chance of precocious death within 60 days was 10.48 times greater than the chance of early death within 30 days.
Conclusion: Most of the deaths occurred within 2 months after the diagnosis, during the intensive phase of the treatment. The use of alcohol and gender were associated with death, revealing inequality between men and women. This study advanced knowledge regarding the vulnerability associated with mortality. These findings must be addressed to fill a gap in the care cascades for active TB and ensure equity in health.
Databáze: MEDLINE
Externí odkaz: