| Autor: |
Jinsoo Min, Ju Sang Kim, Hyung Woo Kim, Ah Young Shin, Hyeon-Kyoung Koo, Sung-Soon Lee, Yang-Ki Kim, Kyeong-Cheol Shin, Jung Hyun Chang, Gayoung Chun, Joosun Lee, Mi Sun Park, Jae Seuk Park |
| Jazyk: |
angličtina |
| Rok vydání: |
2019 |
| Předmět: |
|
| Zdroj: |
BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-10 (2019) |
| Druh dokumentu: |
article |
| ISSN: |
1471-2334 |
| DOI: |
10.1186/s12879-019-4365-9 |
| Popis: |
Abstract Background Although the incidence of tuberculosis (TB) has decreased in South Korea, the mortality rate remains high. TB mortality is a key indicator for TB control interventions. The purpose of this study was to assess early and TB-related mortality during anti-TB treatment and describe the associated clinical characteristics. Methods A multicenter cross-sectional study was performed across South Korea. Patients with pulmonary TB who died during anti-TB treatment and whose records were submitted to the national TB surveillance system between 2015 and 2017 were enrolled. All TB deaths were categorized based on cause (TB-related or non-TB-related) and timing (early or late). We identified statistical associations using the frequency table, chi-square test, and binary logistic regression. Results Of 5595 notifiable mortality cases, 3735 patients with pulmonary TB were included in the analysis. There were 2541 (68.0%) male patients, and 2935 (78.6%) mortality cases were observed in patients older than 65 years. There were 944 (25.3%) cases of TB-related death and 2545 (68.1%) cases of early death. Of all cases, 187 (5.0%) patients were diagnosed post-mortem and 38 (1.0%) patients died on the first day of treatment. Low body mass index (adjusted odds ratio (aOR) = 1.26; 95% confidence interval (CI) = 1.08–1.48), no reported illness (aOR = 1.36; 95% CI = 1.10–1.68), bilateral disease on chest X-ray (aOR = 1.30; 95% CI = 1.11–1.52), and positive acid-fast bacilli smear result (aOR = 1.30; 95% CI = 1.11–1.52) were significantly associated with early death, as well as TB-related death. Acute respiratory failure was the most common mode of non-TB-related death. Malignancy was associated with both late (aOR = 0.71; 95% CI = 0.59–0.89) and non-TB-related (aOR = 0.35; 95% CI = 0.26–0.46) death. Conclusions A high proportion of TB death was observed in elderly patients and attributed to non-TB-related causes. Many TB-related deaths occurred during the intensive phase, particularly within the first month. Further studies identifying risk factors for different causes of TB death at different phases of anti-TB treatment are warranted for early targeted intervention in order to reduce TB mortality. |
| Databáze: |
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