title: Decreased activities of daily living is a strong risk factor for liver injury by anti-tuberculosis drugs.
abstract: OBJECTIVE
  We evaluated the association between activities of daily living and drug-induced liver injury by anti-tuberculosis drugs.
  
  
  METHODS
  This retrospective cohort study included adult inpatients with newly diagnosed smear-positive lung tuberculosis treated with standard regimen in two hospitals. (n = 346; 63.6 ± 20.3 years old; 106 (30.6%) females). Activities of daily living was divided into 'independent' (Barthel Index (BI) 80-100, 60.4%) and 'decreased' (BI 0-75, 39.6%) categories. Liver injury was defined as the withdrawal or change of treatment regimen on the basis of the following criteria: serum transaminase concentrations were more than three times the upper limit of normal range with jaundice and/or hepatitis symptoms, or more than five times the upper limit of the normal range.
  
  
  RESULTS
  Compared with 'independent' patients, patients with 'decreased' activities of daily living had odds ratios for liver injury of 4.2 (P < 0.001) in univariate analysis and 5.7 (P = 0.002) in logistic regression analysis after adjusting for other risk factors.
  
  
  CONCLUSIONS
  Decreased activity of daily living is a strong risk factor for liver injury among adult inpatients with newly diagnosed smear-positive lung tuberculosis treated using a standard regimen.
authors.affiliation: Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. nobuyuki_horita@yahoo.co.jp
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Horita
authors.forename: Naoki
authors.initials: N
authors.lastname: Miyazawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshiyama
authors.forename: Toshinori
authors.initials: T
authors.lastname: Tsukahara
authors.forename: Ryohei
authors.initials: R
authors.lastname: Takahashi
authors.forename: Jun
authors.initials: J
authors.lastname: Tsukiji
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kato
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kaneko
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ishigatsubo
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000995:Antitubercular Agents / Q000009:adverse effects* / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents