Kolappan C, Subramani R, Kumaraswami V, Santha T, Narayanan P R
Tuberculosis Research Centre, Indian Council of Medical Research, Chennai, India.
Int J Tuberc Lung Dis. 2008 Jan;12(1):81-6.
To estimate the excess general mortality among tuberculosis (TB) patients in a rural area (Tiruvallur) and identify risk factors for TB-related mortality.
The study population consisted of all TB patients aged >or=15 years who were registered under the Revised National Tuberculosis Control Programme (RNTCP) during the years 2000 to 2003 at Velliyur TB unit (TU) in south India.
This is a retrospective cohort study of 3405 patients treated under the DOTS strategy, followed up from the date of start of treatment till the date of interview (for the survivors) or the date of death (for those who died).
There were 2710 (79.6%) survivors and 695 (20.4%) deaths. The excess general mortalities for the cohort, expressed as standardised mortality ratio (SMR), was 4.2 (95%CI 3.9-4.5). High SMR values were obtained for patients belonging to the 15-44 years age group (12.1), patients on Category II regimen (9.3), treatment failures (9.1) and defaulters (7.8). The adjusted hazards ratios (aHR) were high for patients aged 45-59 years (1.9), >or=60 years (3.1) and with incomplete treatment due to default or failure (6.4).
TB is one of the main causes of mortality in the younger age group. Among TB patients, the major risk factors for mortality are old age (>or=45 years) and incomplete treatment.
评估印度农村地区（蒂鲁瓦勒尔）结核病（TB）患者的额外总体死亡率，并确定结核病相关死亡的危险因素。
研究人群包括2000年至2003年期间在印度南部韦利尤尔结核病防治所（TU）根据修订的国家结核病控制规划（RNTCP）登记的所有年龄≥15岁的结核病患者。
这是一项对3405例采用直接观察短程治疗（DOTS）策略治疗的患者进行的回顾性队列研究，从治疗开始之日起随访至访谈日期（对于幸存者）或死亡日期（对于死亡者）。
有2710例（79.6%）幸存者和695例（20.4%）死亡者。该队列的额外总体死亡率以标准化死亡率（SMR）表示为4.2（95%可信区间3.9 - 4.5）。15 - 44岁年龄组患者（12.1）、采用II类治疗方案的患者（9.3）、治疗失败者（9.1）和违约者（7.8）的SMR值较高。45 - 59岁患者（1.9）、≥60岁患者（3.1）以及因违约或治疗失败导致治疗不完整的患者（6.4）的调整后风险比（aHR）较高。
结核病是年轻年龄组死亡的主要原因之一。在结核病患者中，死亡的主要危险因素是老年（≥45岁）和治疗不完整。
