Mortality before or during treatment among tuberculosis patients in North Carolina, 1993-2003.
Mortality before or during treatment among tuberculosis patients in North Carolina, 1993-2003.
复制标题
DOI：
--
复制
发表时间：
2011-02
期刊：
影响因子：
--
通讯作者：
L. Nguyen;C. D. Hamilton;Qiang Xia;Jason E. Stout
中科院分区：
文献类型：
--
作者：
L. Nguyen;C. D. Hamilton;Qiang Xia;Jason E. Stout
背景北卡罗来纳州，美国。目的调查北卡罗来纳州结核病（TB）患者死亡的人口学和行为学危险因素。设计：回顾性队列研究1993 - 2003年（含）北卡罗来纳州报告的所有结核病患者。将基于结核病确诊病例报告（RVCT）记录的监测数据集与国家死亡指数（NDI）交叉链接，以确认死亡日期并捕获其他死亡病例。结果在5311例肺结核患者中，181例在开始治疗前死亡，540例在完成治疗前死亡。年龄增加、粟粒性/脑膜疾病和人类免疫缺陷病毒（HIV）感染与治疗前、治疗早期（最初8周）和结核病治疗后期死亡风险增加相关。除这些因素外，过量饮酒（HR 1.62，95%CI 1.13 - 2.32）和住在疗养院（HR 1.65，95%CI 1.20 - 2.29）与治疗前8周死亡风险显著增加相关。结论结核病患者的许多死亡发生在最脆弱的人群中，如老年人或HIV感染者，可能归因于延迟诊断和功能状态差。
SETTING North Carolina, United States. OBJECTIVE To investigate the demographic and behavioral risk factors associated with death among tuberculosis (TB) patients in North Carolina. DESIGN Retrospective cohort of all TB patients reported in North Carolina, 1993-2003 (inclusive). A surveillance dataset based upon Report of Verified Case of Tuberculosis (RVCT) records was cross-linked with the National Death Index (NDI) to confirm date of death and capture additional deaths. RESULTS Among 5311 TB patients, 181 died before initiation of TB treatment, and 540 died before completion of TB treatment. Increasing age, miliary/meningeal disease, and human immunodeficiency virus (HIV) infection were associated with increased risk of death before treatment, during early treatment (initial 8 weeks) and later in TB treatment. In addition to these factors, excess alcohol use (HR 1.62, 95%CI 1.13-2.32) and residence in a nursing home (HR 1.65, 95%CI 1.20-2.29) were associated with a significantly increased risk of death during the first 8 weeks of treatment. CONCLUSION Many of the deaths in TB patients occurred in the most vulnerable populations, such as the elderly or those with HIV infection, and may be attributable to delayed diagnosis and poor functional status.