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

Abstract

Identify the treatment effects and risk factors for mortality in patients with pulmonary tuberculosis receiving antituberculosis treatment under the Directly Observed Treatment Short-Course (DOTS) program to reduce the mortality rate of tuberculosis. A retrospective cohort analysis was conducted on the outcomes of antituberculosis treatment of 7,032 patients with tuberculosis in the DOTS program, in the Tuberculosis Management Information System from 2014 to 2017 in Tianjin, China. The Kaplan–Meier method and multifactor Cox proportional risk regression model were used to analyze the risk factors for mortality during antituberculosis treatment under DOTS. The success rate of antituberculosis treatment was 90.24% and the mortality rate was 4.56% among 7,032 cases of tuberculosis in Tianjin. Cox regression analysis showed that advanced age, male sex, human immunodeficiency virus (HIV) positivity, first sputum positivity, retreated tuberculosis, and a delayed visit (≥14 days) were risk factors for mortality in patients with pulmonary tuberculosis receiving antituberculosis treatment under DOTS. The treatment effects in patients with pulmonary tuberculosis during antituberculosis treatment under DOTS were positive in Tianjin. Advanced age, male sex, HIV positivity, first sputum positivity, retreated tuberculosis, and a delayed visit (≥14 days) increased the risk for mortality during antituberculosis treatment.

Time to Death and Associated Factors among Tuberculosis Patients in South West Ethiopia: Application of Shared Frailty Model

“…According to the result obtained from the multivariable Weibull–Gamma shared frailty model, the risk of death was higher in HIV-positive co-infected TB patients and was statistically associated with the time to death of TB patients during treatment. This finding is consistent with those of a study conducted in the southern region of Ethiopia [ 35 ].…”

“…Thus, a one year increase in the age of TB patients increased the risk of death by 2.2%. This result implies that the age of patients was directly associated with the mortality of TB patients [ 35 , 36 , 37 ]. Similarly, [ 38 ] showed that mortality due to TB was indirectly associated with increasing age.…”

Survival Analysis and Associated Factors for Pulmonary Tuberculosis Death: Evidence from the Information System of Tuberculosis Disease and Mortality Surveillance in China

“…Previous literature has identified age as a potential risk factor for TB survival, suggesting mortality increases by 5.9% with increasing yearly age. 3 The findings of our study further implied the “60–75” age group was a negative influencing factor for long-term survival (five-year survival) and the “75–90” age group was a negative influencing factor for medium/long-term survival (three/five-year survival). For these older age group, affected factors including lower immunity levels, more comorbidities, and delayed diagnosis, might explain the effect on survival time.…”

“…Moreover, the literature has demonstrated that the success rate of retreated patients was lower than that of those initially treated, indicating that retreated PTB cases may have a longer treatment time. 3 Thus, for reasons like longer treatment periods, such beneficial effects may be weakened in the former, and no statistically significant benefits were found for the medium/long-term survival of PTB.…”

“…1 , 2 TB is a chronic infectious respiratory disease caused by Mycobacterium tuberculosis . 3 In recent years, a concerted global effort has been undertaken to eradicate TB and reduce TB-related mortality; consequently, the TB incidence and mortality rate have been decreasing by 1.9% and 3.4% annually, respectively. 4 However, in 2020, a total of 1.5 million people died worldwide due to TB and of them, approximately 214,000 people had HIV.…”