Moosazadeh Mahmood, Bahrampour Abbas, Nasehi Mahshid, Khanjani Narges
Department of Biostatistics and Epidemiology, Faculty of Health, Kerman University of Medical Sciences, Kerman, Iran.
Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Int J Prev Med. 2014 Aug;5(8):1005-12.
Tuberculosis (TB) can affect patients' life even after successful treatment. In this study, we aimed to determine the survival rate of patients with smear positive TB after successful treatment and identify the predictors of mortality.
This was a prospective study. The source of data was the TB registry system in Iran and 964 patients were eligible for the study. The life table was used to determine the annual survival rate. Survival curves were estimated using Kaplan-Meier and were compared using the log-rank test. In order to determine the predictors of survival, four models of Cox regression, exponential, Weibull and log-logistic fitted and finally exponential model with minimum akaike information criteria and Bayesian information criterion values were selected. Then, variables with significant levels <0.2 in univariate analysis were entered into the multivariate model. Hazard ratios with a confidence interval of 95% were used to measure the association.
A total of 149 patients (15.5%) died during the follow-up period. The median of survival time after successful treatment was 10.5 years and survival probability for 11 years after successful treatment was 70%. Furthermore, previous TB treatment, high age, suffering from kidney failure and cancer were predictors of mortality after successful treatment.
This study showed that positive smear pulmonary tuberculosis even after successful treatment has an adverse effect on the patients' survival and leads to a decrease in their survival rate in the long run. Furthermore, individuals with a history of previous TB treatment had much lower survival rates.
结核病（TB）即使在成功治疗后仍会影响患者的生活。在本研究中，我们旨在确定痰涂片阳性结核病患者成功治疗后的生存率，并确定死亡的预测因素。
这是一项前瞻性研究。数据来源是伊朗的结核病登记系统，964名患者符合研究条件。生命表用于确定年生存率。使用Kaplan-Meier估计生存曲线，并使用对数秩检验进行比较。为了确定生存的预测因素，拟合了Cox回归、指数、Weibull和对数逻辑四种模型，最后选择了具有最小赤池信息准则和贝叶斯信息准则值的指数模型。然后，将单变量分析中显著水平<0.2的变量纳入多变量模型。使用95%置信区间的风险比来衡量关联。
共有149名患者（15.5%）在随访期间死亡。成功治疗后的生存时间中位数为10.5年，成功治疗后11年的生存概率为70%。此外，既往结核病治疗史、高龄、患有肾衰竭和癌症是成功治疗后死亡的预测因素。
本研究表明，痰涂片阳性肺结核即使在成功治疗后也会对患者的生存产生不利影响，并最终导致其生存率下降。此外，有既往结核病治疗史的个体生存率要低得多。
