Predictors of death among patients who completed tuberculosis treatment: a population-based cohort study.
Predictors of death among patients who completed tuberculosis treatment: a population-based cohort study.
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DOI：
10.1371/journal.pone.0025315
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Barcelona Tuberculosis Working Group
中科院分区：
文献类型：
--
作者：
Millet JP;Orcau A;Rius C;Casals M;de Olalla PG;Moreno A;Nelson JL;Caylà JA;Barcelona Tuberculosis Working Group
在脆弱人群中，完成结核病治疗的患者死亡率仍然很高。该研究的目的是确定成功治疗的结核病患者队列的死亡概率及其预测因素。在西班牙巴塞罗那进行了一项基于人群的回顾性纵向研究。所有在1995-1997年期间成功完成结核病治疗并进行培养确认和可用药物敏感性测试的患者均由巴塞罗那结核病控制项目回顾性随访至2005年12月31日。对社会人口统计学、临床、微生物学和治疗变量进行了检查。死亡率，结核病规划和艾滋病登记进行了审查。采用Kaplan-Meier和考克斯回归方法（含时间依赖性协变量）进行生存分析，计算风险比（HR）和95%置信区间（CI）。在纳入的762例患者中，中位年龄为36岁，520例（68.2%）为男性，178例（23.4%）为HIV感染者，208例（27.3%）为酒精滥用者。在134名（17.6%）注射吸毒者中，123名（91.8%）感染了艾滋病毒。共发生30例（3.9%）复发和173例（22.7%）死亡（死亡率：3.4/100人-年随访）。死亡的预测因素是：年龄在41-60岁之间（HR：3.5; CI：2.1-5.7），年龄大于60岁（HR：14.6; CI：8.9-24），酗酒（HR：1.7; CI：1.2-2.4）和HIV感染的IDU（HR：7.9; CI：4.7-13.3）。完成治疗的结核病患者的死亡率与老年人、酗酒者和感染艾滋病毒的注射吸毒者等弱势群体有关。因此，我们需要消除贫困，促进和制定针对这些人口的干预措施和社会政策，以改善他们的生存。
Mortality among patients who complete tuberculosis (TB) treatment is still high among vulnerable populations. The objective of the study was to identify the probability of death and its predictive factors in a cohort of successfully treated TB patients. A population-based retrospective longitudinal study was performed in Barcelona, Spain. All patients who successfully completed TB treatment with culture-confirmation and available drug susceptibility testing between 1995–1997 were retrospectively followed-up until December 31, 2005 by the Barcelona TB Control Program. Socio-demographic, clinical, microbiological and treatment variables were examined. Mortality, TB Program and AIDS registries were reviewed. Kaplan-Meier and a Cox regression methods with time-dependent covariates were used for the survival analysis, calculating the hazard ratio (HR) with 95% confidence intervals (CI). Among the 762 included patients, the median age was 36 years, 520 (68.2%) were male, 178 (23.4%) HIV-infected, and 208 (27.3%) were alcohol abusers. Of the 134 (17.6%) injecting drug users (IDU), 123 (91.8%) were HIV-infected. A total of 30 (3.9%) recurrences and 173 deaths (22.7%) occurred (mortality rate: 3.4/100 person-years of follow-up). The predictors of death were: age between 41–60 years old (HR: 3.5; CI:2.1–5.7), age greater than 60 years (HR: 14.6; CI:8.9–24), alcohol abuse (HR: 1.7; CI:1.2–2.4) and HIV-infected IDU (HR: 7.9; CI:4.7–13.3). The mortality rate among TB patients who completed treatment is associated with vulnerable populations such as the elderly, alcohol abusers, and HIV-infected IDU. We therefore need to fight against poverty, and promote and develop interventions and social policies directed towards these populations to improve their survival.
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影响因子：
5.8
作者：
Caylà JA;Rodrigo T;Ruiz-Manzano J;Caminero JA;Vidal R;García JM;Blanquer R;Casals M;Working Group on Completion of Tuberculosis Treatment in Spain (Study ECUTTE)
通讯作者：
Working Group on Completion of Tuberculosis Treatment in Spain (Study ECUTTE)
影响因子：
120.7
作者：
Geng, E;Kreiswirth, B;Schluger, NW
通讯作者：
Schluger, NW
影响因子：
24.3
作者：
Girardi, E;Antonucci, G;Ippolito, G
通讯作者：
Ippolito, G
影响因子：
168.9
作者：
Lopez, Alan D.;Mathers, Colin D.;Murray, Christopher J. L.
通讯作者：
Murray, Christopher J. L.
影响因子：
120.7
作者：
PablosMendez, A;Sterling, TR;Frieden, TR
通讯作者：
Frieden, TR