Initial presentations predict mortality in pulmonary tuberculosis patients - a prospective observational study

Jia Yih Feng, Wei Juin Su, Yu Chi Chiu, Shiang Fen Huang, Yung Yang Lin, Ruay Ming Huang, Ching Hsiung Lin, Jhi Jhu Hwang, Jen Jyh Lee, Ming Chih Yu, Kwok Woon Yu, Yu Chin Lee

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20 Citations (Scopus)

Abstract

Background: Despite effective anti-TB treatments, tuberculosis remains a serious threat to public health and is associated with high mortality. Old age and multiple co-morbidities are known risk factors for death. The association of clinical presentations with mortality in pulmonary tuberculosis patients remains an issue of controversy. Methods: This prospective observational study enrolled newly diagnosed, culture-proven pulmonary tuberculosis patients from five medical centers and one regional hospital, which were referral hospitals of TB patients. Radiographic findings and clinical symptoms were determined at the time of diagnosis. Patients who died for any reason during the course of anti-TB treatment were defined as mortality cases and death that occurred within 30 days of initiating treatment was defined as early mortality. Clinical factors associated with overall mortality and early mortality were investigated. Results: A total of 992 patients were enrolled and 195 (19.7%) died. Nearly one-third (62/195, 31.8%) of the deaths occurred before or within 30 days of treatment initiation. Older age (RR = 1.04, 95%CI: 1.03-1.05), malignancy (RR = 2.42, 95%CI: 1.77-3.31), renal insufficiency (RR = 1.77, 95%CI: 1.12-2.80), presence of chronic cough (RR = 0.63, 95%CI: 0.47-0.84), fever (RR = 1.45, 95%CI: 1.09-1.94), and anorexia (RR = 1.49, 95%CI: 1.07-2.06) were independently associated with overall mortality. Kaplan-Meier survival analysis demonstrated significantly higher mortality in patients present with fever (p

Original languageEnglish
Article numbere23715
JournalPLoS One
Volume6
Issue number9
DOIs
Publication statusPublished - Sep 13 2011

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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    Feng, J. Y., Su, W. J., Chiu, Y. C., Huang, S. F., Lin, Y. Y., Huang, R. M., Lin, C. H., Hwang, J. J., Lee, J. J., Yu, M. C., Yu, K. W., & Lee, Y. C. (2011). Initial presentations predict mortality in pulmonary tuberculosis patients - a prospective observational study. PLoS One, 6(9), [e23715]. https://doi.org/10.1371/journal.pone.0023715