Prognostic Factors in Tuberculosis Related Mortalities in Hospitalized Patients

Abstract

Setting. The study was undertaken at the Department of Pulmonology at a public, tertiary care centre in Karachi, Pakistan. Objectives. To evaluate factors concerned with in-hospital deaths in patients admitted with pulmonary tuberculosis (TB). Design. A retrospective case-control audit was performed for 120 patients hospitalised with pulmonary TB. Sixty of those discharged after treatment were compared to sixty who did not survive. Radiological findings, clinical indicators, and laboratory values were compared between the two groups to identify factors related to poor prognosis. Results. Factors concerned with in-hospital mortality listed late presentation of disease (P < 0.01), noncompliance to antituberculosis therapy (P < 0.01), smoking (P < 0.01), longer duration of illness prior to treatment (P < 0.01), and low body weight (P < 0.01). Most deaths occurred during the first week of admission (P < 0.01) indicating late referrals as significant. Immunocompromised status and multi-drug resistance were not implicated in higher mortality. Conclusions. Poor prognosis was associated with noncompliance to therapy resulting in longer duration of illness, late patient referrals to care centres, and development of complications. Early diagnosis, timely referrals, and monitored compliance may help reduce mortality. Adherence to a more radically effective treatment regimen is required to eliminate TB early during disease onset.

Mortality of patients hospitalized for active tuberculosis in King Abdulaziz University Hospital, Jeddah, Saudi Arabia

“… 5 However, it is lower in comparison to China (18.9%), 12 Korea (30.4%), 13 the Philippines (37.5%), 14 and Pakistan (42.5%). 15 The differences in mortality rates between these countries may be due to the difference in the patient populations studied, which could be influenced by ethnic backgrounds and comorbidities. It is important to note that TB mortality rates from long-term studies of ambulatory patients rather than hospitalized patients are generally lower.…”

Factors affecting mortality and treatment completion of tuberculosis patients in Isfahan Province from 2006 to 2011

“…The results of this study indicated that the variable weight had no significant effect on the death and the completion outcome of the treatment. Some studies indicated that low body weight is a risk factor for death [ 28 ] and is also a risk factor for recurrence of the disease. [ 29 ] In contrast body weight at initiation of anti-TB treatment (<35 kg) was an independent predictor for death.…”

Could neutrophil to lymphocyte ratio be a prognostic predictor of relapse in patients with extra-pulmonary tuberculosis?

“…Better understanding of the prognosis factors associated with relapse is an important issue to identify patients at high risk of relapse and promises to reduce the disease burden through risk factors interventions. Several prognosis factors of TB have been reported such as noncompliance to anti-tuberculosis therapy, smoking, longer duration of illness prior to treatment and low body weight (1).…”

“…It has been declared as a worldwide health emergency since the last two decades (1). According to annual surveys conducted by the World Health Organization (WHO), 10.4 million cases of TB and 1.7 million deaths occurred in 2016 (2).…”