title: Prognostic factors in tuberculosis related mortalities in hospitalized patients.
abstract: Setting. The study was undertaken at the Department of Pulmonology at a public, tertiary care centre in Karachi, Pakistan. Objectives. To evaluate factors concerned with in-hospital deaths in patients admitted with pulmonary tuberculosis (TB). Design. A retrospective case-control audit was performed for 120 patients hospitalised with pulmonary TB. Sixty of those discharged after treatment were compared to sixty who did not survive. Radiological findings, clinical indicators, and laboratory values were compared between the two groups to identify factors related to poor prognosis. Results. Factors concerned with in-hospital mortality listed late presentation of disease (P < 0.01), noncompliance to antituberculosis therapy (P < 0.01), smoking (P < 0.01), longer duration of illness prior to treatment (P < 0.01), and low body weight (P < 0.01). Most deaths occurred during the first week of admission (P < 0.01) indicating late referrals as significant. Immunocompromised status and multi-drug resistance were not implicated in higher mortality. Conclusions. Poor prognosis was associated with noncompliance to therapy resulting in longer duration of illness, late patient referrals to care centres, and development of complications. Early diagnosis, timely referrals, and monitored compliance may help reduce mortality. Adherence to a more radically effective treatment regimen is required to eliminate TB early during disease onset.
authors.affiliation: Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Rafiqui H J Shaheed Road, Karachi 75510, Pakistan.
authors.forename: Ghazal
authors.identifier: 0000-0002-0024-780X
authors.initials: G
authors.lastname: Haque
authors.affiliation: Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Rafiqui H J Shaheed Road, Karachi 75510, Pakistan.
authors.forename: Ashok
authors.identifier: 0000-0003-4685-2631
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Rafiqui H J Shaheed Road, Karachi 75510, Pakistan.
authors.forename: Fatima
authors.identifier: 0000-0002-4504-9743
authors.initials: F
authors.lastname: Saifuddin
authors.affiliation: Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Rafiqui H J Shaheed Road, Karachi 75510, Pakistan.
authors.forename: Shafaq
authors.initials: S
authors.lastname: Ismail
authors.affiliation: Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Rafiqui H J Shaheed Road, Karachi 75510, Pakistan.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Rizvi
authors.affiliation: Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Rafiqui H J Shaheed Road, Karachi 75510, Pakistan.
authors.forename: Shaista
authors.initials: S
authors.lastname: Ghazal
authors.affiliation: Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Rafiqui H J Shaheed Road, Karachi 75510, Pakistan.
authors.forename: Sadhna
authors.identifier: 0000-0002-0903-4851
authors.initials: S
authors.lastname: Notani