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Clinical profiles of early and tuberculosis-related mortality in South Korea between 2015 and 2017: a cross-sectional study

Title
Clinical profiles of early and tuberculosis-related mortality in South Korea between 2015 and 2017: a cross-sectional study
Authors
Min, JinsooKim, Ju SangKim, Hyung WooShin, Ah YoungKoo, Hyeon-KyoungLee, Sung-SoonKim, Yang-KiShin, Kyeong-CheolChang, Jung HyunChun, GayoungLee, JoosunPark, Mi SunPark, Jae Seuk
Ewha Authors
장중현
SCOPUS Author ID
장중현scopus
Issue Date
2019
Journal Title
BMC INFECTIOUS DISEASES
ISSN
1471-2334JCR Link
Citation
BMC INFECTIOUS DISEASES vol. 19, no. 1
Keywords
Private-public mixPPMDeathElderlyKorea
Publisher
BMC
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
BackgroundAlthough the incidence of tuberculosis (TB) has decreased in South Korea, the mortality rate remains high. TB mortality is a key indicator for TB control interventions. The purpose of this study was to assess early and TB-related mortality during anti-TB treatment and describe the associated clinical characteristics.MethodsA multicenter cross-sectional study was performed across South Korea. Patients with pulmonary TB who died during anti-TB treatment and whose records were submitted to the national TB surveillance system between 2015 and 2017 were enrolled. All TB deaths were categorized based on cause (TB-related or non-TB-related) and timing (early or late). We identified statistical associations using the frequency table, chi-square test, and binary logistic regression.ResultsOf 5595 notifiable mortality cases, 3735 patients with pulmonary TB were included in the analysis. There were 2541 (68.0%) male patients, and 2935 (78.6%) mortality cases were observed in patients older than 65years. There were 944 (25.3%) cases of TB-related death and 2545 (68.1%) cases of early death. Of all cases, 187 (5.0%) patients were diagnosed post-mortem and 38 (1.0%) patients died on the first day of treatment. Low body mass index (adjusted odds ratio (aOR)=1.26; 95% confidence interval (CI)=1.08-1.48), no reported illness (aOR=1.36; 95% CI=1.10-1.68), bilateral disease on chest X-ray (aOR=1.30; 95% CI=1.11-1.52), and positive acid-fast bacilli smear result (aOR=1.30; 95% CI=1.11-1.52) were significantly associated with early death, as well as TB-related death. Acute respiratory failure was the most common mode of non-TB-related death. Malignancy was associated with both late (aOR=0.71; 95% CI=0.59-0.89) and non-TB-related (aOR=0.35; 95% CI=0.26-0.46) death.ConclusionsA high proportion of TB death was observed in elderly patients and attributed to non-TB-related causes. Many TB-related deaths occurred during the intensive phase, particularly within the first month. Further studies identifying risk factors for different causes of TB death at different phases of anti-TB treatment are warranted for early targeted intervention in order to reduce TB mortality.
DOI
10.1186/s12879-019-4365-9
Appears in Collections:
의과대학 > 의학과 > Journal papers
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