Kwon Oh Beom, Kim Hyung Woo, Kim Ju Sang, Lee Eung Gu, Park Yeonhee, Jung Sung Soo, Kim Jin Woo, Oh Jee Youn, Lee Sang Haak, Kim Seunghoon, Kim Sun-Hyung, Lyu Jiwon, Ko Yousang, Kwon Sun Jung, Chae Ganghee, Min Jinsoo
Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Korean Med Sci. 2025 May 5;40(17):e73. doi: 10.3346/jkms.2025.40.e73.
The increasing incidence and mortality rates of tuberculosis among older individuals who suffer from multiple morbidities and are vulnerable to malnutrition are major obstacles to efforts to eradicate tuberculosis in the Republic of Korea. Herein, we identified the factors associated with mortality during anti-tuberculosis treatment in patients with pulmonary tuberculosis.
We conducted a case-control study and extracted data from the database of a multi-center prospective observational cohort study in Korea. Among the participants with rifampicin-susceptible pulmonary tuberculosis, the survival group was defined as those who successfully completed treatment within one year, whereas the mortality group was defined as those who died during treatment. Univariable and multivariable logistic regression analyses were performed to identify factors associated with TB mortality.
Among 1,119 participants with pulmonary TB registered between 2019 and 2021, 799 and 59 were grouped in the survival and mortality groups, respectively. Age, positive smear results, alarming symptoms, nutrition risk score, Charlson comorbidity index score, and initial standard treatment regimen were significant based on univariable analysis and were selected for the multivariable logistic regression model. Nutrition risk score (adjusted odds ratio, 2.44; 95% confidence interval, 1.72-3.48) and Charlson comorbidity index score (adjusted odds ratio, 1.62; 95% confidence interval, 1.35-1.94) remained statistically significant in the multivariate analysis.
Nutritional status and comorbidities at baseline were identified as important factors associated with mortality in patients with pulmonary tuberculosis.
在患有多种疾病且易患营养不良的老年人群中，结核病发病率和死亡率不断上升，这是韩国根除结核病努力的主要障碍。在此，我们确定了肺结核患者抗结核治疗期间与死亡率相关的因素。
我们进行了一项病例对照研究，并从韩国一项多中心前瞻性观察队列研究的数据库中提取数据。在对利福平敏感的肺结核参与者中，生存组定义为在一年内成功完成治疗的患者，而死亡组定义为在治疗期间死亡的患者。进行单变量和多变量逻辑回归分析以确定与结核病死亡率相关的因素。
在2019年至2021年登记的1119例肺结核参与者中，分别有799例和59例被归入生存组和死亡组。根据单变量分析，年龄、涂片阳性结果、警示症状、营养风险评分、查尔森合并症指数评分和初始标准治疗方案具有统计学意义，并被选入多变量逻辑回归模型。在多变量分析中，营养风险评分（调整后的优势比，2.44；95%置信区间，1.72 - 3.48）和查尔森合并症指数评分（调整后的优势比，1.62；95%置信区间，1.35 - 1.94）仍具有统计学意义。
基线时的营养状况和合并症被确定为肺结核患者死亡率的重要相关因素。
