Tuberculosis mortality: patient characteristics and causes

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• 作者：Chou-Han Lin (1)
  Chou-Jui Lin (2)
  Yao-Wen Kuo (3)
  Jann-Yuan Wang (3)
  Chia-Lin Hsu (3)
  Jong-Min Chen (3)
  Wern-Cherng Cheng (4)
  Li-Na Lee (4)
  
• 关键词：Tuberculosis ; Mortality ; Risk factor
• 刊名：BMC Infectious Diseases
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：214 KB
• 作者单位：Chou-Han Lin (1)
  Chou-Jui Lin (2)
  Yao-Wen Kuo (3)
  Jann-Yuan Wang (3)
  Chia-Lin Hsu (3)
  Jong-Min Chen (3)
  Wern-Cherng Cheng (4)
  Li-Na Lee (4)
  
  1. Department of Internal Medicine, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist, New Taipei City, Taiwan
  2. Department of Internal Medicine, Tao-Yuan General Hospital, No.1492, Chung-Shan Road, Taoyuan City, Taoyuan County, Taiwan
  3. Department of Internal Medicine, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, Taiwan
  4. Department of Laboratory Medicine, National Taiwan University College of Medicine and Hospital, No.7, Chung-Shan South Road, Taipei, 10002, Taiwan
  
• ISSN：1471-2334

文摘

Background In the antibiotic era, tuberculosis (TB) still causes a substantial number of mortalities. We aimed to identify the causes and risks of death among TB patients. Methods Medical records of mortality cases of culture-proven TB diagnosed during 2003-007 were reviewed. All TB deaths were classified into 2 groups (TB-related and non-TB-related), based on the underlying cause of death. Results During the study period, 2016 cases (male: 71.1%) of culture-proven TB were identified. The mean age was 59.3 (range: 0.3-6) years. The overall mortality rate was 12.3% (249 cases) and the mean age at death was 74 years; 17.3% (43 cases) of all TB deaths were TB-related. Most of the TB-related deaths occurred early (median survival: 20 days), and the patient died of septic shock. Malignancy, liver cirrhosis, renal failure, and miliary and pneumonic radiographic patterns were all independent predictors for all TB deaths. Cavitary, miliary and pneumonic radiographic patterns were all significant predictive factors for TB-related death. Extrapulmonary involvement and liver cirrhosis were also factors contributing to TB-related death. Conclusions The majority of TB deaths were ascribed to non-TB-related causes. Managing TB as well as underlying comorbidities in a multidisciplinary approach is essential to improve the outcome of patients in an aging population. However, the clinical manifestations of patients with TB-related death vary; many progressed to fulminant septic shock requiring timely recognition with prompt treatment to prevent early death.