未经治疗的结核病患者的生存率:时间,地理和环境的影响
C A Rodriguez1, S V Leavitt2, T C Bouton3
1Departments of Epidemiology, and.
概括
未经治疗的结核病 (TB) 的存活率在化学治疗前的数据中因地理位置和治疗环境而有显著差异. 这些历史生存差异对于了解现代未诊断的结核病例至关重要.
科学领域:
- 流行病学 流行病学
- 历史医学 历史医学
- 生物统计学 生物统计学
背景情况:
- 据估计,2021年约40%的结核病 (TB) 病例仍未被诊断或治疗.
- 化疗前的医学文献为未经治疗的结核病患者的生存提供了宝贵的见解.
- 了解历史生存数据对于准确估计当代未诊断结核病患者的结果至关重要.
研究的目的:
- 分析化疗前结核病存活率数据中的异质性.
- 为当代结核病研究准确应用历史数据提供信息.
主要方法:
- 从报告结核病特异性死亡率或自然恢复的化学治疗前研究中系统地提取生存数据.
- 应用贝叶斯参数生存分析来模型生存分布.
- 根据地理位置 (北美与欧洲),时间段 (1930年之前与1930年之后) 和治疗环境 (卫生院与非卫生院) 的数据分层.
主要成果:
- 分析包括12项报告结核病特异性死亡率的研究.
- 十年生存率差异很大:北美69%,欧洲36%.
- 与非卫生机构 (38%) 相比,在卫生机构 (69%) 的10年生存率更高.
- 在1930年前 (65%) 和1930年后 (72%) 诊断期间之间,没有观察到5年生存率的显著差异.
结论:
- 根据地理位置和治疗环境,结核病死亡率和自然恢复风险存在显著差异.
- 化疗前的数据显示了大量的异质性,在推断未诊断结核病患者的预期生存期时必须考虑这些异质性.
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