Tuberculosis mortality and associated factors at King Abdulaziz Medical City Hospital

Abstract Background Tuberculosis (TB) continues to be a public health challenge in Saudi Arabia, particularly for the elderly. This study was conducted to estimate mortality per 1000 person-year among TB and resistant TB cases and to identifying factors associated with mortality. Methods This is a r...

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Main Authors: Rawabi Aljadani, Anwar E. Ahmed, Hamdan AL-Jahdali
Format: Article
Language:English
Published: BMC 2019-05-01
Series:BMC Infectious Diseases
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12879-019-4063-7
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spelling doaj-77ff14cc5ad440f6b27e92ed44ff331a2020-11-25T03:58:29ZengBMCBMC Infectious Diseases1471-23342019-05-011911710.1186/s12879-019-4063-7Tuberculosis mortality and associated factors at King Abdulaziz Medical City HospitalRawabi Aljadani0Anwar E. Ahmed1Hamdan AL-Jahdali2Saudi Food and Drug AuthorityKing Saud bin Abdulaziz University for Health SciencesKing Saud bin Abdulaziz University for Health SciencesAbstract Background Tuberculosis (TB) continues to be a public health challenge in Saudi Arabia, particularly for the elderly. This study was conducted to estimate mortality per 1000 person-year among TB and resistant TB cases and to identifying factors associated with mortality. Methods This is a retrospective cohort study of 713 new TB cases at King Abdulaziz Medical City in Riyadh diagnosed between January 1, 2000, and December 31, 2016. Patient medical records and microbiology lab databases were used to identify TB cases. Through reviews were conducted of patients’ medical records, including physician notes, physical examinations, radiology (scans and imaging), laboratory tests, and follow-up notes. Collected data include demographic information, clinical features, diagnoses, comorbidities, and death rates. Results Of the 713 TB patients included in this study, 110 died, giving an average mortality rate of 22 per 1000 person-years (PY; 95% CI: 18.2–26.4). Elderly patients (≥ 60 years) had a higher mortality rate of 36.5 per 1000 PY (95% CI: 28.9–45.5). As age increases by one year, the hazard of mortality increase by 2.4% (aHR: 1.024 [95% CI: 1.009–1.039, P = 0.002]). Higher hazard of mortality was found among males (aHR: 2.014 [95% CI: 1.186–3.418, P = 0.010]). Patients with respiratory and other types of comorbidities and cancer had a higher mortality hazard (aHR: 1.898 [95% CI: 1.005–3.582, P = 0.048]; aHR: 2.346 [95% CI: 1.313–4.192, P = 0.004]; aHR: 3.292 [95% CI: 1.804–6.006, P = 0.001]), respectively. Multidrug-resistant TB (MDR-TB) was found in 2 cases (0.28%) (95% CI: 0.08–1.02), 1.68% were resistant to only one antibiotic, 0.14% had rifampicine-resistant TB (RR-TB), 0.28% had MDR-TB, and 0.14% had extensively drug-resistant TB (XDR-TB). Conclusions The mortality rate among TB patients was found to be 22 per 1000 person-year at our center. TB was associated with high mortality rates among males, the elderly, and patients with cancer, respiratory illness, and other comorbidities. Future clinical practice should include establishing an efficient TB diagnostic program and continued hazard assessment of TB treatment options.http://link.springer.com/article/10.1186/s12879-019-4063-7TuberculosisMortalityMultidrug-resistant
collection DOAJ
language English
format Article
sources DOAJ
author Rawabi Aljadani
Anwar E. Ahmed
Hamdan AL-Jahdali
spellingShingle Rawabi Aljadani
Anwar E. Ahmed
Hamdan AL-Jahdali
Tuberculosis mortality and associated factors at King Abdulaziz Medical City Hospital
BMC Infectious Diseases
Tuberculosis
Mortality
Multidrug-resistant
author_facet Rawabi Aljadani
Anwar E. Ahmed
Hamdan AL-Jahdali
author_sort Rawabi Aljadani
title Tuberculosis mortality and associated factors at King Abdulaziz Medical City Hospital
title_short Tuberculosis mortality and associated factors at King Abdulaziz Medical City Hospital
title_full Tuberculosis mortality and associated factors at King Abdulaziz Medical City Hospital
title_fullStr Tuberculosis mortality and associated factors at King Abdulaziz Medical City Hospital
title_full_unstemmed Tuberculosis mortality and associated factors at King Abdulaziz Medical City Hospital
title_sort tuberculosis mortality and associated factors at king abdulaziz medical city hospital
publisher BMC
series BMC Infectious Diseases
issn 1471-2334
publishDate 2019-05-01
description Abstract Background Tuberculosis (TB) continues to be a public health challenge in Saudi Arabia, particularly for the elderly. This study was conducted to estimate mortality per 1000 person-year among TB and resistant TB cases and to identifying factors associated with mortality. Methods This is a retrospective cohort study of 713 new TB cases at King Abdulaziz Medical City in Riyadh diagnosed between January 1, 2000, and December 31, 2016. Patient medical records and microbiology lab databases were used to identify TB cases. Through reviews were conducted of patients’ medical records, including physician notes, physical examinations, radiology (scans and imaging), laboratory tests, and follow-up notes. Collected data include demographic information, clinical features, diagnoses, comorbidities, and death rates. Results Of the 713 TB patients included in this study, 110 died, giving an average mortality rate of 22 per 1000 person-years (PY; 95% CI: 18.2–26.4). Elderly patients (≥ 60 years) had a higher mortality rate of 36.5 per 1000 PY (95% CI: 28.9–45.5). As age increases by one year, the hazard of mortality increase by 2.4% (aHR: 1.024 [95% CI: 1.009–1.039, P = 0.002]). Higher hazard of mortality was found among males (aHR: 2.014 [95% CI: 1.186–3.418, P = 0.010]). Patients with respiratory and other types of comorbidities and cancer had a higher mortality hazard (aHR: 1.898 [95% CI: 1.005–3.582, P = 0.048]; aHR: 2.346 [95% CI: 1.313–4.192, P = 0.004]; aHR: 3.292 [95% CI: 1.804–6.006, P = 0.001]), respectively. Multidrug-resistant TB (MDR-TB) was found in 2 cases (0.28%) (95% CI: 0.08–1.02), 1.68% were resistant to only one antibiotic, 0.14% had rifampicine-resistant TB (RR-TB), 0.28% had MDR-TB, and 0.14% had extensively drug-resistant TB (XDR-TB). Conclusions The mortality rate among TB patients was found to be 22 per 1000 person-year at our center. TB was associated with high mortality rates among males, the elderly, and patients with cancer, respiratory illness, and other comorbidities. Future clinical practice should include establishing an efficient TB diagnostic program and continued hazard assessment of TB treatment options.
topic Tuberculosis
Mortality
Multidrug-resistant
url http://link.springer.com/article/10.1186/s12879-019-4063-7
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