Longevity loss among cured tuberculosis patients and the potential value of prevention
Longevity loss among cured tuberculosis patients and the potential value of prevention
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DOI：
10.5588/ijtld.14.0242
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发表时间：
2014-11-01
影响因子：
4
通讯作者：
Miller, T. L.
中科院分区：
文献类型：
--
作者：
Hoger, S.;Lykens, K.;Miller, T. L.
背景：即使在抗结核治疗和治愈后，仍有大量的、可量化的和可预防的死亡危险负担的证据将是衡量预防价值的一个令人信服的、具体的和有用的措施。方法：我们比较了3 933名结核病治愈患者和9 166名潜伏性结核感染患者的潜在寿命损失年数。我们构建了一个回归模型来预测每个队列和人口亚组的预期潜在寿命损失年数。结果：在死者中，与没有活动性结核病的可比人群相比，完全治疗的结核病史与预测的平均3.6年潜在生命损失相关。与黑人和亚洲人相比，白人和西班牙裔人的寿命下降幅度更大。结论：我们发现治疗过的结核病幸存者的预期寿命与没有活动性结核病的相似组有显著差异。这些额外的损失是巨大的：总共14 158个生命年或相当于超过188个75岁的寿命。这些发现说明了与每个可预防结核病病例相关的重要机会成本，即平均3.6潜在寿命年。我们的结论是，尽管有适当的抗结核治疗，但大量可预防的死亡率负担仍然存在，这是更广泛和系统地使用预防措施的令人信服的理由。
BACKGROUND: Evidence of substantial, quantifiable and preventable burdens of mortality hazard even after anti-tuberculosis treatment and cure would be a compelling, concrete, and useful measure of the value of prevention.METHODS: We compared years of potential life lost between a cohort of 3 933 cured tuberculosis (TB) patients and 9 166 persons with latent tuberculous infection. We constructed a regression model to predict the expected years of potential life lost in each cohort and for demographic subgroups.RESULTS: Among decedents, a history of fully treated TB is associated with a predicted average 3.6 more years of potential life loss than a comparable population without active TB. Greater longevity losses were predicted among those identified as White and Hispanic than among Black and Asian counterparts.CONCLUSION: We found significant differences in predicted longevity of treated TB survivors relative to a similar group without active TB. These excess losses are substantial: a total of 14 158 life-years or the equivalent of more than 188 75-year lifespans. These findings illustrate an important opportunity cost associated with each preventable TB case an average of 3.6 potential years of life. We conclude that substantial preventable mortality burdens remain despite adequate anti-tuberculosis treatment, a compelling rationale for more widespread and systematic use of prevention.