[Excess mortality due to tuberculosis and factors associated to death in and annual cohort of patients diagnosed of tuberculosis].
OBJECTIVE
To calculate excess mortality in an annual cohort of tuberculosis patients and study the factors associated with death.


METHODS
Cases of tuberculosis reported in Catalonia (May 1996-April 1997). Patients were classified as completed treatment/cured (compliant), non-compliant, failures, transfers out and deaths. Excess mortality was defined as the ratio actual deaths/expected deaths (according to general mortality figures for Catalonia, May 1996-April 1997). Factors associated with death were determined by a comparative study of variables (demographic, substance abuse, comorbidity, tuberculosis-related disease) in deaths after diagnosis and survivors. Time from diagnosis to death was recorded.


RESULTS
Patients included: 2,085. Patients classified as: completed treatment/cured (compliant), 1,406 (67.43 %); noncompliant, 165 (7, 91%); failures, 5 (0.24%); transfers out, 25 (1.21%); deaths, 133 (6.38%), 28 of which occurred before diagnosis and 105 after diagnosis. Insufficient data in medical record for classification, 351 (16.83%) patients. Excess mortality: 5.98 (95% CI: 4.96-7.0). Factors associated with death: treatment with non-standardized guidelines, 46%; OR: 10.3 (6.2-17.4); HIV infection, 40%; OR: 13.0 (6.6-25.8); age greater than 64 years, 40%; OR: 14.6 (3.0-69.8); alcoholism, 25%; OR: 2.0 (1.1-3.6); neoplasm, 16%; OR: 3.9 (1.8-8.6; renal failure, 8%; OR: 10.1 (3.1-32.3). The shortest time from diagnosis to death was in patients with only one risk factor, except for HIV infection, where the time passed was the longest observed.


CONCLUSIONS
We found substantial excess mortality in tuberculosis patients. Death was associated with the efficacy of treatment, HIV coinfection, advanced age, alcoholism and the coexistence of neoplasms or renal failure.
Pina
J M
JM
Programa de la Tuberculosi de la Regió Sanitária Centre de Catalunya, Barcelona, España. 4940jpg@comb.es
Domínguez
A
A
Alcaide
J
J
Alvarez
J
J
Camps
N
N
Díez
M
M
Godoy
P
P
Jansá
J M
JM
Minquell
S
S
Arias
C
C
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002423:Cause of Death; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D014376:Tuberculosis / Q000188:drug therapy / Q000401:mortality*
D000995:Antitubercular Agents