Tuberculosis in Lorraine, France: study of prognostic factors

To identify factors predicting short-term mortality in patients with tuberculosis in the Lorraine region of France.

Retrospective survey in nine voluntarily participating hospitals between January 1990 and December 1994.

In total 351 files were analyzed. The average age of patients was 49 +/- 19 years; 77% were of French origin, 60% were male; 35% were in paid employment at the time of the diagnosis, 42% were unemployed and 23% were retired. Twenty-three patients were infected by the human immunodeficiency virus (HIV), and 34 patients had a prior history of tuberculosis; 79% of all cases were exclusively pulmonary, 14% were exclusively extra-pulmonary (more frequent in women) and 7% were mixed. Extra-pulmonary sites of involvement were more frequent in HIV-infected patients. Chest X-ray was suggestive of tuberculosis in 158 patients with pulmonary involvement, and non-suggestive in 145 (more frequently in HIV-infected patients). In univariate analysis, HIV co-infection, increasing age and unemployment were linked to death during treatment. In multivariate analysis (logistic regression), HIV co-infection, old age, unemployment, pulmonary involvement and French origin were significantly linked to the risk of death during treatment.