Clinical profiles of early and tuberculosis-related mortality in South Korea between 2015 and 2017: a cross-sectional studyopen access
- Authors
- Min, Jinsoo; Kim, Ju Sang; Kim, Hyung Woo; Shin, Ah Young; Koo, Hyeon-Kyoung; Lee, Sung-Soon; Kim, Yang-Ki; Shin, Kyeong-Cheol; Chang, Jung Hyun; Chun, Gayoung; Lee, Joosun; Park, Mi Sun; Park, Jae Seuk
- Issue Date
- 22-Aug-2019
- Publisher
- BioMed Central
- Keywords
- Private-public mix; PPM; Death; Elderly; Korea
- Citation
- BMC Infectious Diseases, v.19, no.1
- Journal Title
- BMC Infectious Diseases
- Volume
- 19
- Number
- 1
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/4305
- DOI
- 10.1186/s12879-019-4365-9
- ISSN
- 1471-2334
- 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.
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