Department of Clinical Epidemiology and Health Economics School of Public Health, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Department of Real World Evidence, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Respir Investig. 2024 Jul;62(4):520-525. doi: 10.1016/j.resinv.2024.04.004. Epub 2024 Apr 17.
Miliary tuberculosis (TB) is a fatal disease; thus, prompt diagnosis and immediate intervention are indispensable. However, the risk factors for in-hospital mortality in patients with miliary TB remain unclear. Therefore, this study aimed to identify the factors associated with in-hospital mortality in patients with miliary TB using a Japanese nationwide inpatient database.
Patients diagnosed with miliary TB between July 2010 and March 2022 were enrolled from the Diagnosis Procedure Combination database. Multivariate logistic regression analyses were performed to identify the factors associated with in-hospital mortality in patients with miliary TB.
In total, 2817 patients with miliary TB and 637 (22.6%) in-hospital deaths were identified. Older age; male sex (odds ratio [OR], 1.30; 95% confidence interval [CI], 1.04-1.64); low body weight (OR, 1.41; 95% CI, 1.14-1.76); altered consciousness; a low Barthel index score; chronic respiratory failure (OR, 3.85; 95% CI, 1.61-9.19); hematologic malignancy (OR, 2.60; 95% CI, 1.26-5.35); conditions requiring oxygenation (OR, 1.70; 95% CI, 1.37-2.10) or high-flow nasal cannula therapy (OR, 2.78; 95% CI, 1.01-7.62); or the administration of vasopressors (OR, 2.25; 95% CI, 1.39-3.63) or antibiotics (OR, 1.40; 95% CI, 1.14-1.74) were associated with higher in-hospital mortality.
This study identified the factors affecting in-hospital mortality among patients with miliary TB. The findings of this study will aid clinicians in identifying patients who may benefit from aggressive therapeutic interventions.
粟粒性结核病（TB）是一种致命疾病；因此，及时诊断和立即干预是必不可少的。然而，粟粒性 TB 患者院内死亡的危险因素尚不清楚。因此，本研究旨在使用日本全国住院患者数据库确定粟粒性 TB 患者院内死亡的相关因素。
从诊断程序组合数据库中招募了 2010 年 7 月至 2022 年 3 月期间诊断为粟粒性 TB 的患者。进行多变量逻辑回归分析，以确定粟粒性 TB 患者院内死亡的相关因素。
共纳入 2817 例粟粒性 TB 患者和 637 例（22.6%）院内死亡患者。年龄较大；男性（比值比[OR]，1.30；95%置信区间[CI]，1.04-1.64）；低体重（OR，1.41；95% CI，1.14-1.76）；意识改变；低巴氏量表评分；慢性呼吸衰竭（OR，3.85；95% CI，1.61-9.19）；血液系统恶性肿瘤（OR，2.60；95% CI，1.26-5.35）；需要氧疗（OR，1.70；95% CI，1.37-2.10）或高流量鼻导管治疗（OR，2.78；95% CI，1.01-7.62）；或使用血管加压素（OR，2.25；95% CI，1.39-3.63）或抗生素（OR，1.40；95% CI，1.14-1.74）与较高的院内死亡率相关。
本研究确定了影响粟粒性 TB 患者院内死亡的因素。本研究的结果将有助于临床医生识别可能受益于积极治疗干预的患者。
