Comparing the Factors Correlated with Tuberculosis-Specific and Non-Tuberculosis-Specific Deaths in Different Age Groups among Tuberculosis-Related Deaths in Taiwan

Abstract

BackgroundNearly 20% of tuberculosis (TB) patients die within one year, and TB-related mortality rates remain high in Taiwan. The study aimed to identify factors correlated with TB-specific deaths versus non-TB-specific deaths in different age groups among TB-related mortalities.MethodsA retrospective cohort study was conducted from 2006-2008 with newly registered TB patients receiving follow-up for 1 year. The national TB database from the Taiwan-CDC was linked with the National Vital Registry System and the National Health Insurance database. A chi-squared test and logistic regression were used to analyse the correlated factors related to TB-specific and non-TB-specific deaths in different age groups.ResultsElderly age (odds ratio [OR] 2.68-8.09), Eastern residence (OR 2.01), positive sputum bacteriology (OR 2.54), abnormal chest X-ray (OR 2.28), and comorbidity with chronic kidney disease (OR 2.35), stroke (OR 1.74) or chronic liver disease (OR 1.29) were most likely to be the cause of TB-specific deaths, whereas cancer (OR 0.79) was less likely to be implicated. For non-TB-specific deaths in patients younger than 65 years of age, male sex (OR 2.04) and comorbidity with HIV (OR 5.92), chronic kidney disease (OR 8.02), stroke (OR 3.75), cancer (OR 9.79), chronic liver disease (OR 2.71) or diabetes mellitus (OR 1.38) were risk factors.ConclusionsDifferent factors correlated with TB-specific deaths compared with non-TB-specific deaths, and the impact of comorbidities gradually decreased as age increased. To reduce TB-specific mortality, special consideration for TB patients with old age, Eastern residence, positive sputum bacteriology and comorbidity with chronic kidney disease or stroke is crucial. In particular, Eastern residence increased the risk of TB-specific death in all age groups. In terms of TB deaths among patients younger than 65 years of age, patients with HIV, chronic kidney disease or cancer had a 6-10 times increased risk of non-TB-specific deaths.

Survival Analysis of Risk Factors for Mortality in a Cohort of Patients with Tuberculosis

“…Age is a risk factor for the survival of patients with TB. The risk of death increases by 5.9% (RR = 1.059, 95% CI = 1.051–1.067) with each year of increase in age, which is consistent with the results of other studies [ 18 , 19 , 25 ]. This finding may be related to low immunity, atypical symptoms, long onset time, more basic diseases, and poor health awareness in elderly patients.…”

Adverse Outcomes after Non-Chest Surgeries in Patients with Pulmonary Tuberculosis: A Nationwide Study

“…Previous studies indicated that the older people, active phase, more coexisting medical diseases, lower socioeconomic status, opportunistic infection emergency care for TB and high-dose medication of TB were the factor associated with the higher incidence and mortality of TB [ 29 – 35 ]. However, the impact of these clinical scenarios on perioperative outcomes after surgery in TB patients remains unknown.…”

The use of bedaquiline to treat patients with multidrug-resistant tuberculosis and end-stage renal disease: A case report

“…End-stage renal disease (ESRD) is a well-known risk factor for active TB. Atypical/serious drug reactions occur frequently during TB treatment, and TB-specific mortality is higher in patients with ESRD (British Thoracic Society Standards of Care Committee and Joint Tuberculosis Committee et al, 2010;Wu et al, 2015). QT prolongation is common in ESRD patients and may be an independent predictor of mortality (Hage et al, 2010).…”