Comparing the Factors Correlated with Tuberculosis-specific and Non-tuberculosis-specific Deaths in Different Age Groups Among Tuberculosis-related Deaths in Taiwan

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Mar 4

PMID 25734444

Citations 9

Authors

Yi-Chun Wu

Hsiu-Yun Lo

Shiang-Lin Yang

Da-Chen Chu

Pesus Chou

Affiliations

Soon will be listed here.

Abstract

Background: Nearly 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.

Methods: A 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.

Results: Elderly 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.

Conclusions: Different 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.

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References

Lin H, Deng C, Chou P . Diagnosis and treatment delay among pulmonary tuberculosis patients identified using the Taiwan reporting enquiry system, 2002-2006. BMC Public Health. 2009; 9:55. PMC: 2654887. DOI: 10.1186/1471-2458-9-55. View

Barnes H, Barnes L . The Duration of Life in Pulmonary Tuberculosis with Cavity. Trans Am Climatol Clin Assoc. 2011; 44:39-55. PMC: 2262276. View

Sterling T, Zhao Z, Khan A, Chaisson R, Schluger N, Mangura B . Mortality in a large tuberculosis treatment trial: modifiable and non-modifiable risk factors. Int J Tuberc Lung Dis. 2006; 10(5):542-9. View

Low S, Ang L, Cutter J, James L, Chee C, Wang Y . Mortality among tuberculosis patients on treatment in Singapore. Int J Tuberc Lung Dis. 2009; 13(3):328-34. View

Wu Y, Lin R, Yang S, Lu T . Assessing the quality of tuberculosis-related underlying cause of death assignment in Taiwan, 2001-2005. J Formos Med Assoc. 2008; 107(1):30-6. DOI: 10.1016/S0929-6646(08)60005-4. View

Arcavi L, Benowitz N . Cigarette smoking and infection. Arch Intern Med. 2004; 164(20):2206-16. DOI: 10.1001/archinte.164.20.2206. View

Lo H, Suo J, Chang H, Yang S, Chou P . Risk factors associated with death in a 12-month cohort analysis of tuberculosis patients: 12-month follow-up after registration. Asia Pac J Public Health. 2011; 27(2):NP758-68. DOI: 10.1177/1010539511429591. View

Vasankari T, Holmstrom P, Ollgren J, Liippo K, Kokki M, Ruutu P . Risk factors for poor tuberculosis treatment outcome in Finland: a cohort study. BMC Public Health. 2007; 7:291. PMC: 2099439. DOI: 10.1186/1471-2458-7-291. View

Chien J, Huang R, Wang J, Ruan S, Chien Y, Yu C . Hepatitis C virus infection increases hepatitis risk during anti-tuberculosis treatment. Int J Tuberc Lung Dis. 2010; 14(5):616-21. View

10.

Yu M, Bai K, Chang J, Lee C . Tuberculosis incidence and mortality in aboriginal areas of Taiwan, 1997-2001. J Formos Med Assoc. 2004; 103(11):817-23. View

11.

Shen X, DeRiemer K, Yuan Z, Shen M, Xia Z, Gui X . Deaths among tuberculosis cases in Shanghai, China: who is at risk?. BMC Infect Dis. 2009; 9:95. PMC: 2702371. DOI: 10.1186/1471-2334-9-95. View

12.

Khan F, Minion J, Pai M, Royce S, Burman W, Harries A . Treatment of active tuberculosis in HIV-coinfected patients: a systematic review and meta-analysis. Clin Infect Dis. 2010; 50(9):1288-99. DOI: 10.1086/651686. View

13.

Dooley K, Tang T, Golub J, Dorman S, Cronin W . Impact of diabetes mellitus on treatment outcomes of patients with active tuberculosis. Am J Trop Med Hyg. 2009; 80(4):634-9. PMC: 2750857. View

14.

Inghammar M, Ekbom A, Engstrom G, Ljungberg B, Romanus V, Lofdahl C . COPD and the risk of tuberculosis--a population-based cohort study. PLoS One. 2010; 5(4):e10138. PMC: 2854124. DOI: 10.1371/journal.pone.0010138. View

15.

Libshitz H, Pannu H, Elting L, Cooksley C . Tuberculosis in cancer patients: an update. J Thorac Imaging. 1997; 12(1):41-6. DOI: 10.1097/00005382-199701000-00006. View

16.

Lui S, Tang S, Li F, Choy B, Chan T, Lo W . Tuberculosis infection in Chinese patients undergoing continuous ambulatory peritoneal dialysis. Am J Kidney Dis. 2001; 38(5):1055-60. DOI: 10.1053/ajkd.2001.28599. View

17.

Yung-Ming C, Bao-Ying T, Yi-Chun W, Shih-Yan Y, Chang-Hsun C . Risk of Mycobacterium tuberculosis transmission in an aboriginal village, Taiwan. Southeast Asian J Trop Med Public Health. 2007; 37 Suppl 3:161-4. View