肺结核患者治疗期间死亡的决定因素：Cox比例风险模型

Determinant factors for mortality during treatment among tuberculosis patients: Cox proportional hazards model.

作者信息

Abedi Siavosh, Moosazadeh Mahmood, Afshari Mahdi, Charati Jamshid Yazdani, Nezammahalleh Asghar

机构信息

Department of Internal Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

Indian J Tuberc. 2019 Jan;66(1):39-43. doi: 10.1016/j.ijtb.2017.05.001. Epub 2017 May 19.

DOI:10.1016/j.ijtb.2017.05.001

PMID:30797281

Abstract

BACKGROUND

Investigating the survival of tuberculosis (TB) patients is one of the main parts of the TB control program. It can be related to many factors. This study aimed to estimate the survival experience and its associated factors among these patients.

METHODOLOGY

All TB patients detected during March 2005 to 31 September 2014 were entered into this prospective cohort. Each patient was investigated from the diagnosis date and followed until the last available information during treatment. Data analysis was performed using Kaplan Meier and multivariate Cox regression models.

RESULTS

The survival experience of 2493 TB patients was investigated 73.7% of which were pulmonary type. Mean and median survival time were 6.5 and 6.2 months respectively. The incidence rate of death among patients during the treatment courses was 0.99 (95% confidence interval: 0.84-1.1) per 100 person-months. Controlling the confounders, the incidence (95% confidence interval) of death was significantly higher among men (HR=1.8; 1.2-2.6), diabetic patients (HR=1.7; 1.2-2.6), cancerous patients (HR=4.8; 2.6-8.8) and HIV positive patients (HR=22.1; 7.3-66.4).

CONCLUSION

This study showed that male gender, TB/HIV co-infection and concurrent development of TB and cancer were determinant factors of death during the treatment period of TB.

摘要

背景

调查结核病（TB）患者的生存率是结核病控制项目的主要内容之一。其可能与许多因素相关。本研究旨在评估这些患者的生存情况及其相关因素。

方法

2005年3月至2014年9月31日期间确诊的所有结核病患者纳入该前瞻性队列研究。从诊断日期开始对每位患者进行调查，并随访至治疗期间的最后可用信息。采用Kaplan Meier法和多变量Cox回归模型进行数据分析。

结果

对2493例结核病患者的生存情况进行了调查，其中73.7%为肺结核类型。平均生存时间和中位生存时间分别为6.5个月和6.2个月。治疗期间患者的死亡发生率为每100人月0.99（95%置信区间：0.84 - 1.1）。在控制混杂因素后，男性（HR = 1.8；1.2 - 2.6）、糖尿病患者（HR = 1.7；1.2 - 2.6）、癌症患者（HR = 4.8；2.6 - 8.8）和HIV阳性患者（HR = 22.1；7.3 - 66.4）的死亡发生率（95%置信区间）显著更高。