Association of Body Mass Index with Timing of Death during Tuberculosis Treatment

Abstract

BackgroundThe association between body mass index and mortality in patients with tuberculosis has not been extensively studied, and the existing evidence is inconsistent. This study aimed to investigate the impact of body mass index on timing of death in patients with tuberculosis.MethodsAll Taiwanese adults with tuberculosis in Taipei, Taiwan, were included in a retrospective cohort study in 2011–2012. Multinomial logistic regression was used to evaluate the association between body mass index and timing of death in patients with tuberculosis.ResultsAmong 1557 eligible patients, 84.1% (1310), 8.2% (128), and 7.6% (119) underwent successful treatment, early death, and late death, respectively. The mean age of the patients with tuberculosis was 64.2 years old, and 67.7% were male. After controlling for potential confounding variables, underweight with body mass index less than 18.5 kg/ m2 was significantly associated with elevated risk of all-cause mortality [Adjusted odds ratio (AOR), 1.64; 95% confidence interval (CI), 1.17–2.30]. Considering timing of death, underweight with body mass index less than 18.5 was significantly associated only with elevated risk of early mortality within the first 8 weeks of treatment onset (AOR, 2.22; 95% CI, 1.45–3.40)ConclusionsFor patients with tuberculosis infection, underweight with body mass index less than 18.5 kg/ m2 is an independent predictor for early mortality within the first 8 weeks of treatment.

Management of multidrug-resistant tuberculosis with shorter treatment regimen in Niger: Nationwide programmatic achievements

“…All patients who died presented with a poor clinical condition at diagnosis. Severe underweight was an important predictor of mortality, consistent with findings from other settings [25,26]. We speculate that reducing the delay in treatment initiation will decrease mortality in the future [27].…”

Diabetes, undernutrition, migration and indigenous communities: tuberculosis in Chiapas, Mexico

“…We found that deaths were more likely among TB patients with HIV or undernutrition, which is consistent with the literature [22,23,45]. In contrast, DM was not associated with higher deaths, a finding consistent with our previous studies in Mexico, but not with reports from other populations [9,[46][47][48].…”

Underweight increases the risk of early death in tuberculosis patients

“…The association of BMI with TB outcome was inconsistent in previous reports ( 4 , 7 – 12 ) . Four studies found that lower BMI was significantly associated with a higher risk of mortality among TB patients ( 8 – 10 , 12 ) , with one study reporting that greater BMI (per unit increase) was significantly associated with a lower risk of mortality ( 8 ) . In contrast, another two studies found no differences in the risk of mortality based on BMI (<18·5 v .…”

“…Although many studies have evaluated the risk factors for mortality in TB patients ( 6 ) , the association between BMI and mortality in this population has not been studied extensively, and the existing evidence is inconsistent ( 4 , 7 – 12 ) . Some studies reported that lower BMI was significantly associated with a higher risk of mortality among TB patients ( 7 – 10 , 12 ) , whereas another two found no such an association ( 4 , 11 ) . Moreover, one study found that overweight was a protective factor for mortality among TB patients ( 7 ) .…”