Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
Mycobacterial Centre for Research Southern Denmark-MyCRESD, Odense, Denmark.
PLoS One. 2020 Jun 4;15(6):e0231821. doi: 10.1371/journal.pone.0231821. eCollection 2020.
Mortality from tuberculosis (TB) has been declining since 2000, nevertheless there is still a significant number of patients who die before or during TB treatment. The aims were to examine and describe predictors associated with TB related mortality.
Patients notified with TB from 2009 though 2014 in Denmark were included. Data were extracted from national registers and patient records were examined for clinical information and treatment outcome. Cox proportional hazards regression was used to examine TB related mortality.
A total of 2131 cases were identified, 141 (6.6%) patients died before or during TB treatment. TB related mortality accounted for 104 cases (73.8%) and decreased significantly from 6.7% to 3.2% (p = .04) during the study period. Within 1 months of diagnosis, 49% of TB related deaths had occurred. The strongest risk factors present at time of diagnosis, associated with TB related mortality, were: age > 70 years, Charlson comorbidity index > 1, alcohol abuse, weight loss, anemia, and C-reactive protein > 100 mg/L (p < .05).
The majority of TB related deaths occurred soon after diagnosis, emphasizing that TB patients identified to have a high risk of mortality should be closely monitored before and during the intensive treatment period to improve their outcomes.
自 2000 年以来,结核病(TB)的死亡率一直在下降,但仍有相当数量的患者在接受 TB 治疗之前或期间死亡。本研究旨在探讨并描述与 TB 相关死亡相关的预测因素。
本研究纳入了 2009 年至 2014 年期间在丹麦被诊断为结核病的患者。数据从国家登记处提取,对患者记录进行检查以获取临床信息和治疗结果。采用 Cox 比例风险回归分析来研究 TB 相关死亡。
共确定了 2131 例病例,其中 141 例(6.6%)患者在接受 TB 治疗之前或期间死亡。TB 相关死亡率为 104 例(73.8%),在研究期间显著从 6.7%下降至 3.2%(p =.04)。在诊断后 1 个月内,49%的 TB 相关死亡发生。在诊断时存在的最强风险因素,与 TB 相关死亡相关,包括:年龄 > 70 岁、Charlson 合并症指数 > 1、酗酒、体重减轻、贫血和 C 反应蛋白 > 100mg/L(p <.05)。
大多数 TB 相关死亡发生在诊断后不久,这强调了 TB 患者被识别为具有高死亡风险时,应在强化治疗期间密切监测,以改善其预后。