Tuberculosis mortality: patient characteristics and causes

Abstract

BackgroundIn the antibiotic era, tuberculosis (TB) still causes a substantial number of mortalities. We aimed to identify the causes and risks of death among TB patients.MethodsMedical records of mortality cases of culture-proven TB diagnosed during 2003–2007 were reviewed. All TB deaths were classified into 2 groups (TB-related and non-TB-related), based on the underlying cause of death.ResultsDuring the study period, 2016 cases (male: 71.1%) of culture-proven TB were identified. The mean age was 59.3 (range: 0.3–96) years. The overall mortality rate was 12.3% (249 cases) and the mean age at death was 74 years; 17.3% (43 cases) of all TB deaths were TB-related. Most of the TB-related deaths occurred early (median survival: 20 days), and the patient died of septic shock. Malignancy, liver cirrhosis, renal failure, and miliary and pneumonic radiographic patterns were all independent predictors for all TB deaths. Cavitary, miliary and pneumonic radiographic patterns were all significant predictive factors for TB-related death. Extrapulmonary involvement and liver cirrhosis were also factors contributing to TB-related death.ConclusionsThe majority of TB deaths were ascribed to non-TB-related causes. Managing TB as well as underlying comorbidities in a multidisciplinary approach is essential to improve the outcome of patients in an aging population. However, the clinical manifestations of patients with TB-related death vary; many progressed to fulminant septic shock requiring timely recognition with prompt treatment to prevent early death.

Factors influencing development and mortality of acute respiratory failure in hospitalized patient with active pulmonary tuberculosis: a 10-year retrospective review

“…Our study also confirmed the findings of previous studies that delayed initiation of anti-tuberculosis agents was an independent factor of respiratory failure and worse clinical outcomes (5,19,20,32). Therefore, patients suspected of acute tuberculous pneumonia need to be considered for development of acute respiratory failure and antituberculosis agents must not be delayed in such patients.…”

“…Half of the patients required mechanical ventilator support. The overall mortality rate was 30.2% which is comparable to previous reports (5,(19)(20)(21). We found that shorter duration of illness, underlying disease of AIDS, development of fever and dyspnea on presentation, large amount of acid fast bacilli on sputum smear, lower serum albumin level, and delayed initiation of anti-tuberculosis agents were among the independent risk factors to develop acute respiratory failure requiring mechanical ventilator support.…”

“…The range of overall mortality rates of patients infected with Mycobacterium tuberculosis is 4% to 65% (2)(3)(4)(5)(6)(7). From previous studies, acute respiratory failure was also indicated as a mortality risk in pulmonary tuberculosis.…”

“…From previous studies, acute respiratory failure was also indicated as a mortality risk in pulmonary tuberculosis. Although the incidence of acute respiratory failure induced by pulmonary tuberculosis from a previous observational study was approximately 1.5%, mortality of the patients with pulmonary tuberculosis who developed acute respiratory failure and required mechanical ventilation ranged between 47% and 80% (4,5,(7)(8)(9)(10)(11)(12). The mortality rate of active pulmonary tuberculosis requiring mechanical ventilation (TBMV) was double the mortality rate of patients with severe bacterial pneumonia who developed acute respiratory failure (13).…”

Tuberculosis Control Program in Sistan: An Eligible Model of A Tropical Area: Environmental and Epidemiological Reasons for Tuberculosis Resistance

“…An epidemiological study of Yang et al showed the tuberculosis incidence and related burden was decreased in wenchuan earthquake-stricken area from 2004-2012 [24]. Lin et al in a study on TB mortal cases showed that patients with inappropriate organ function were in the risk of septicemia and fatality [25]. The Human Immunodeficiency Virus infection is another [26] related risk factor.…”