Tuberculosis deaths in a tertiary hospital in Goiânia, Brazil: a descriptive study

Tuberculosis (TB) remains a serious global public health problem, being the main cause of death in patients with AIDS, and the third cause of death by infectious diseases throughout the world. This is somewhat surprising because TB is a disease that, if treated properly, displays high rates of healing. It is therefore important to characterise these patients to identify target populations for specific measures seeking to reduce TB deaths. We performed a retrospective descriptive study to analyse the cases of TB deaths in a State public hospital, a point of reference for treatment of infectious diseases, located in the Central-West region of Brazil, in the period from January 1st, 2008 to December 31st, 2009. There were 283 diagnosed and reported cases of TB between 2008 and 2009, and 39 recorded deaths occurred, resulting in a lethality index of 14%. The mean age of TB patients was 42 years, and the median age 37 years. Pulmonary TB was the most common form of TB (51.3% of the patients). Of the 39 TB patients who died, 56.4% (n = 22) were co-infected with HIV. The main immediate causes of death were acute respiratory failure (n = 12) and sepsis (n = 8). Anaemia and hypoalbuminaemia were prevalent in this group, and 27 patients required mechanical ventilation. This study found that hospitalized patients who died had the following characteristics: bilateral pulmonary disease, low levels of haemoglobin and haematocrit, albumin, and those co-infected with HIV that were admitted to the ICU required MV. Prospective studies aiming to analyse the risk factors for death from TB are needed to better understand this process.