Zhang Peize, Xiong Juan, Zeng Jianfeng, Zhan Senlin, Chen Tao, Wang Yuxiang, Deng Guofang
Department of Pulmonary Medicine and Tuberculosis, The Third People's Hospital of Shenzhen, Shenzhen, Guangdong, People's Republic of China.
School of Public Health, Health Science Center, Shenzhen University, Shenzhen, Guangdong, People's Republic of China.
Int J Gen Med. 2021 Jan 22;14:237-242. doi: 10.2147/IJGM.S291146. eCollection 2021.
The aim of this study was to assess active tuberculosis-related deaths in Shenzhen city of China to identify major causes of mortality in different age groups.
Medical records of mortality cases of patients with active TB diagnosed during 2013-2018 were reviewed. All TB deaths were classified into two broad age groups (the young group: 18-65 years old and the elderly group: >65 years old). Causes of death were analyzed based on medical records.
A total of 279 mortality cases of active TB were reviewed during the study period. Among them, mean age was 54.0±20.5 years old; 80.6% (225/279) were male. There were 5.7% and 4.6% MDR/XDRTB patients in the young and elderly group. Newly treated TB accounted for 89.6% in the young group and 85.1% in the elderly group. Pulmonary TB was a major infection type in both groups (65.1% vs 77.0%). Advanced TB (23.4%) and HIV co-infection (20.8%) were the leading causes of deaths in the young group, but deaths in the elderly group were mostly associated with underlying diseases, including cardiovascular disease (52.9%), diabetes (33.3%), COPD (16.1%) and cancer (11.5%). Malnutrition was a significant condition in both groups (43.2% vs 35.6%). In terms of respiratory complications, bacterial infection was the leading comorbidity in both groups (27.1% vs 18.4%), followed by septic shock (18.2% vs 12.6%) and respiratory failure (12.0% vs 11.5%). There were no significant statistical differences between the two groups.
Our findings suggest that screening for HIV co-infection and early diagnosis of TB is vital in lowering TB-related deaths in young patients. Most deaths in elderly TB patients were caused by underlying health conditions or complications other than TB.
本研究旨在评估中国深圳市活动性结核病相关死亡情况，以确定不同年龄组的主要死亡原因。
回顾了2013 - 2018年期间诊断为活动性肺结核患者的死亡病历。所有结核病死亡病例分为两个 broad 年龄组（青年组：18 - 65岁；老年组：>65岁）。根据病历分析死亡原因。
研究期间共回顾了279例活动性肺结核死亡病例。其中，平均年龄为54.0±20.5岁；80.6%（225/279）为男性。青年组和老年组中耐多药/广泛耐药结核病患者分别占5.7%和4.6%。青年组新治疗的结核病占89.6%，老年组占85.1%。肺结核是两组的主要感染类型（65.1%对77.0%）。晚期结核病（23.4%）和HIV合并感染（20.8%）是青年组的主要死亡原因，但老年组的死亡大多与基础疾病有关，包括心血管疾病（52.9%）、糖尿病（33.3%）、慢性阻塞性肺疾病（16.1%）和癌症（11.5%）。营养不良在两组中均为显著情况（43.2%对35.6%）。在呼吸并发症方面，细菌感染是两组的主要合并症（27.1%对18.4%），其次是感染性休克（18.2%对12.6%）和呼吸衰竭（12.0%对11.5%）。两组之间无显著统计学差异。
我们的研究结果表明，筛查HIV合并感染和早期诊断结核病对于降低年轻患者的结核病相关死亡至关重要。老年结核病患者的大多数死亡是由结核病以外的基础健康状况或并发症引起的。
