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2008 - 2018年土耳其与院内结核病死亡率相关的社会人口统计学和临床风险因素

Sociodemographic and clinical risk factors associated with in-hospital tuberculosis mortality in Türkiye, 2008-2018.

作者信息

Gayaf Mine, Ayik Türk Merve, Özdemir Özer, Polat Gülru, Karaman Onur, Güldaval Filiz, Ari Gülsüm, Tatar Dursun, Erbaycu Ahmet Emin

机构信息

Clinic of Pulmonology, Health Sciences University, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Türkiye.

Clinic of Pulmonology, Health Sciences University, İzmir Bozyaka Training and Research Hospital, İzmir, Türkiye.

出版信息

Tuberk Toraks. 2024 Mar;72(1):59-70. doi: 10.5578/tt.202401864.

Abstract

INTRODUCTION

Tuberculosis (TB) is an infectious disease that can be fatal if left untreated or poorly treated, and it is associated with many morbidities. Deaths may provide better understanding of the associated factors and help guide interventions to reduce mortality. In this study, it was aimed to reveal some of the features that predict hospital mortality in patients with TB and to present some alarming findings for clinicians.

MATERIALS AND METHODS

Patients who had been hospitalized with the diagnosis of TB between January 2008 and December 2018 were included and analyzed retrospectively. In-hospital mortality because of any TB disease after the initiation of treatment in patients admitted to the TB Ward and the primary cause of mortality were taken as endpoint.

RESULT

A total of 1321 patients with a mean age of 50.1 years were examined. Total mortality was 39.4% (521 deaths) and 13.1% were in-hospital deaths (173 deaths). Of the deaths, 61.8% (n= 107) occurred during the first month after TB treatment were started. On univariate analysis, age over 48.5 years, Charlson comorbidity index, extension of radiological involvement, hypoalbuminemia and lymphopenia were most predictive variables with higher odds ratios (respectively, p<0.001 for all).

CONCLUSIONS

In-hospital tuberculosis disease mortality is related with older age, cavitary or extensive pulmonary involvement, low albumin levels, unemployment, cigarette smoking and especially those with concomitant malignancy and chronic pulmonary disease.

摘要

引言

结核病是一种传染病,若不治疗或治疗不当可能致命,且与多种疾病相关。死亡情况有助于更好地了解相关因素,并指导采取干预措施降低死亡率。本研究旨在揭示结核病患者医院死亡率的一些预测特征,并为临床医生提供一些警示性发现。

材料与方法

纳入并回顾性分析2008年1月至2018年12月期间因结核病诊断住院的患者。以结核病病房收治患者开始治疗后因任何结核病导致的院内死亡率及主要死亡原因作为终点。

结果

共检查了1321例平均年龄为50.1岁的患者。总死亡率为39.4%(521例死亡),院内死亡率为13.1%(173例死亡)。在死亡病例中,61.8%(n = 107)发生在结核病治疗开始后的第一个月。单因素分析显示,年龄超过48.5岁、Charlson合并症指数、放射学累及范围、低白蛋白血症和淋巴细胞减少是最具预测性的变量,比值比更高(所有p均<0.001)。

结论

院内结核病死亡率与年龄较大、有空洞或广泛肺部累及、白蛋白水平低、失业、吸烟有关,尤其是那些伴有恶性肿瘤和慢性肺部疾病的患者。

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