Overall and cause-specific mortality among patients with tuberculosis and multidrug-resistant tuberculosis
Overall and cause-specific mortality among patients with tuberculosis and multidrug-resistant tuberculosis
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DOI：
10.5588/ijtld.12.0946
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发表时间：
2013-07-01
影响因子：
4
通讯作者：
Rahu, M.
中科院分区：
文献类型：
--
作者：
Bloendal, K.;Rahu, K.;Rahu, M.
目的：评估结核病（TB）和耐多药结核病（MDR-TB）患者的总体和特定原因死亡率在Estonia.DESIGN：2002年1月1日至2009年12月31日，共2449例确诊为活动性呼吸道结核病的患者进行了回顾性随访，直至2011年12月31日。结果：肺结核患者全因死亡的SMR男性为5.30（95%CI 4.85-5.75），女性为10.00（95%CI 8.25-11.74）。耐多药结核病患者结核病死亡的相对风险高于非耐多药结核病患者（男性校正RR为2.98，95%CI为2.00-4.44，女性校正RR为3.26，95%CI为1.42-7.50）。在成功治疗的患者队列中，男性全因死亡率的SMR为3.46（95%CI 3.08-3.84），女性为6.24（95%CI 4.86-7.88）。较低的教育水平和外国族裔导致了较高的死亡风险。与成功治疗的非耐多药结核病相比，既往成功治疗耐多药结核病的病史并没有增加死亡风险。结论：成功治疗的结核病和耐多药结核病患者的死亡率仍然高于一般人群。它受到外国种族和较低教育程度的影响，但重要的是，不受耐多药结核病既往史的影响。
OBJECTIVE: To assess overall and cause-specific mortality among patients with tuberculosis (TB) and multidrug-resistant tuberculosis (MDR-TB) in Estonia.DESIGN: A total of 2449 patients diagnosed with active respiratory TB from 1 January 2002 to 31 December 2009 were followed up retrospectively until 31 December 2011. To estimate the risk of death, standardised mortality ratios (SMR) and mortality rate ratios (RR) were calculated.RESULTS: The SMR for all-cause mortality among those diagnosed with TB was 5.30 (95% CI 4.85-5.75) in males and 10.00 (95%CI 8.25-11.74) in females. The relative risk of death from TB was higher among MDR-TB patients (adjusted RR in males 2.98, 95%CI 2.00-4.44, and in females 3.26, 95 %CI 1.42-7.50) than among non-MDR-TB patients. Among the cohort of successfully treated patients, the SMR for all-cause mortality was 3.46 (95%CI 3.08-3.84) in males and 6.24 (95%CI 4.86-7.88) in females. Lower education level and foreign ethnicity contributed to the higher risk of mortality. Previous history of successfully treated MDR-TB did not increase the risk of death compared to successfully treated non-MDR-TB.CONCLUSIONS: Mortality among successfully treated TB and MDR-TB patients remained higher than among the general population. It was influenced by foreign ethnicity and lower education but, importantly, not by previous history of MDR-TB.