Hoger S, Lykens K, Beavers S F, Katz D, Miller T L
Tarleton State University, Fort Worth, Texas, USA.
University of North Texas Health Science Center, Fort Worth, Texas, USA.
Int J Tuberc Lung Dis. 2014 Nov;18(11):1347-52. doi: 10.5588/ijtld.14.0242.
Evidence of substantial, quantifiable and preventable burdens of mortality hazard even after anti-tuberculosis treatment and cure would be a compelling, concrete, and useful measure of the value of prevention.
We compared years of potential life lost between a cohort of 3 933 cured tuberculosis (TB) patients and 9 166 persons with latent tuberculous infection. We constructed a regression model to predict the expected years of potential life lost in each cohort and for demographic subgroups.
Among decedents, a history of fully treated TB is associated with a predicted average 3.6 more years of potential life loss than a comparable population without active TB. Greater longevity losses were predicted among those identified as White and Hispanic than among Black and Asian counterparts.
We found significant differences in predicted longevity of treated TB survivors relative to a similar group without active TB. These excess losses are substantial: a total of 14 158 life-years or the equivalent of more than 188 75-year lifespans. These findings illustrate an important opportunity cost associated with each preventable TB case - an average of 3.6 potential years of life. We conclude that substantial preventable mortality burdens remain despite adequate anti-tuberculosis treatment, a compelling rationale for more widespread and systematic use of prevention.
即使在接受抗结核治疗并治愈后，仍存在大量、可量化且可预防的死亡风险负担，这将是衡量预防价值的一项令人信服、具体且有用的指标。
我们比较了3933名治愈的结核病患者队列与9166名潜伏结核感染人群之间的潜在寿命损失年数。我们构建了一个回归模型，以预测每个队列以及人口亚组的预期潜在寿命损失年数。
在死者中，与无活动性结核病的可比人群相比，接受过充分治疗的结核病病史与预计平均多3.6年的潜在寿命损失相关。预计白人和西班牙裔人群的寿命损失比黑人和亚裔人群更大。
我们发现，相对于无活动性结核病的类似群体，接受治疗的结核病幸存者的预计寿命存在显著差异。这些额外损失相当大：总计14158个生命年，相当于超过188个75岁的寿命。这些发现说明了每个可预防的结核病病例所带来的重要机会成本——平均3.6年的潜在寿命。我们得出结论，尽管有充分的抗结核治疗，但仍存在大量可预防的死亡负担，这是更广泛、系统地使用预防措施的一个令人信服的理由。
