[Clinical evaluation of causes of death in patients with pulmonary tuberculosis]

We evaluated the cause of death in patients with active tuberculosis.

40 patients (male 32, female 8, mean age 76 years old), died under treatment for tuberculosis during 1999 to 2002 in our hospital, were analized. We compared patients' backgrounds, complications, extent of pulmonary tuberculosis, and outcome of the treatment between 40 died cases and 162 patients who were supposed to be successfully treated by cohort analysis (control group).

17 cases died of tuberculosis and 23 cases died of non-tuberculous diseases. Pneumonia occupied the top (9 cases) in the latter group. Died cases were higher in age and showed larger performance status score than the control group. Further, laboratory findings revealed poorer nutritional conditions and higher inflammatory reactions in the died group. The duration of symptoms before admission seemed to be longer in the died group, however, the difference with the control was not significant. All of the died group had complications and the rate of having liver diseases and cerebrovascular diseases was higher than that of the control group. Furthermore, the extent of lung lesions was more extensive in the died group. The frequency of changing drugs due to side effects was higher in the died group, therefore, the proportion of cases completed the standard treatment was lower in the died group.

Impossibility of continuing the standard treatment gave unfavorable impact in the died cases rather than the delay in their admission. Due to the above reasons, negative conversion of their sputum culture was difficult, and they died of tuberculosis directly or indirectly. Some of the patients who died of pneumonia (non-tuberculous death) might be included in cases died of tuberculosis.