Factors correlated with tuberculosis reported after death.

SETTING

Taiwan.

OBJECTIVE

To determine factors associated with tuberculosis (TB) reported after death.

DESIGN

A retrospective cohort study was conducted of TB patients newly registered between 2006 and 2008. The national TB database was linked with the Vital Registry System and National Health Insurance database for analysis.

RESULTS

A total of 1409 (4.0%) TB cases were reported after death. Age ⩾75 years (OR 1.70), chest X-ray (CXR) unknown or not performed (OR 2.41), positive sputum bacteriology (OR 1.74), and comorbidities such as cancer (OR 1.21), chronic liver disease (OR 1.21) and chronic kidney disease (OR 2.58) were associated with the reporting of TB cases after death. More than 30% of TB deaths in elderly persons with chronic kidney disease were TB cases that were reported after death. Abnormal CXR and comorbidities such as chronic obstructive pulmonary disease, stroke and diabetes mellitus were less likely to be associated with the reporting of TB cases after death.

CONCLUSIONS

Elderly patients with cancer, chronic liver disease or chronic kidney disease require more attention to prevent delayed diagnosis and early mortality from TB. Elderly patients with chronic kidney disease are at highest risk.