Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Sci Rep. 2019 Sep 10;9(1):12995. doi: 10.1038/s41598-019-49439-9.
Monitoring of tuberculosis (TB) treatment outcome is essential to ensure an effective TB control program. In this nationwide retrospective cohort study from Denmark we present TB treatment outcome rates and risk factors associated with an unfavourable outcome. All patients notified with pulmonary TB from 2009 through 2014 were included. Logistic regression analyses were used to identify risk factors for unfavourable outcome. In total, 1681 pulmonary TB cases were included. TB treatment success rates increased during the study period. In 2014, the treatment success rate reached 85% for new culture positive cases whereas 7% cases interrupted treatment. The mortality decreased during the study period from 12.3% to 4.1%. Several risk factors associated with unfavourable outcome were identified in a multivariable model: male (OR: 2.56), Greenlandic origin (OR: 1.80), abuse of alcohol (OR: 2.90), history of mental disorder (OR: 2.46), and anaemia at time of treatment initiation (OR: 1.92). In a TB low incidence setting such as the Danish, it is important to maintain focus on preventing an unfavourable TB outcome. Patient management and treatment can be optimized by taking into consideration risk factors such as those identified in the present study.
监测结核病（TB）治疗结果对于确保有效的结核病控制计划至关重要。在这项来自丹麦的全国性回顾性队列研究中，我们介绍了结核病治疗结果率和与不良结果相关的危险因素。所有 2009 年至 2014 年期间经通知患有肺结核的患者均被纳入研究。我们使用逻辑回归分析来确定不良结果的危险因素。共有 1681 例肺结核病例被纳入研究。在研究期间，结核病治疗成功率有所提高。2014 年，新的培养阳性病例的治疗成功率达到 85%，而中断治疗的病例占 7%。在研究期间，死亡率从 12.3%下降至 4.1%。在多变量模型中确定了与不良结果相关的几个危险因素：男性（OR：2.56）、格陵兰血统（OR：1.80）、酗酒（OR：2.90）、精神障碍史（OR：2.46）和治疗开始时贫血（OR：1.92）。在丹麦这样结核病发病率较低的环境中，重要的是要继续关注预防不良的结核病结果。通过考虑本研究中确定的危险因素，可以优化患者管理和治疗。
