Factors associated with mortality in patients with tuberculosis

Area of Science:

• Public Health
• Epidemiology
• Infectious Diseases

Background:

• Traditional tuberculosis (TB) mortality risk factors may not apply to current U.S. populations.
• This study investigates factors linked to all-cause mortality in Washington State TB patients.

Purpose of the Study:

• To identify demographic, clinical, and behavioral factors associated with all-cause mortality in tuberculosis patients.
• To evaluate the impact of treatment characteristics on tuberculosis-related mortality.

Main Methods:

• A cohort study analyzed data from Washington State's Tuberculosis Information Management System (1993-2005).
• All-cause mortality was determined using the Washington State Death Certificate Data Files.
• Proportional hazards models assessed the independent effects of patient characteristics on mortality.

Main Results:

• Of 3451 patients, 417 deaths occurred during a median 6-year follow-up.
• Increased mortality was associated with older age, male gender, HIV coinfection, and U.S. birth.
• Treatment by a private provider and directly observed therapy within one year of diagnosis were linked to higher mortality.

Conclusions:

• Several factors were independently associated with increased all-cause mortality after tuberculosis diagnosis.
• The relationship between provider type, directly observed therapy, and mortality warrants further investigation, accounting for illness severity.