title: Adverse Outcomes after Non-Chest Surgeries in Patients with Pulmonary Tuberculosis: A Nationwide Study.
abstract: BACKGROUND
  The association between pulmonary tuberculosis (TB) and postoperative outcomes remains unknown. This study investigated outcomes following non-chest surgeries in patients with previous pulmonary TB.
  
  
  METHODS
  Using Taiwan's National Health Insurance Research Database, we analyzed 6911 patients (aged ≥ 20 years) with preoperative diagnosis of pulmonary TB and 6911 propensity score-matched controls receiving non-chest surgeries in 2008-2010. Postoperative outcomes were compared between patients with or without pulmonary TB by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs) in the multivariate logistic regressions.
  
  
  RESULTS
  Surgical patients with pulmonary TB had a significantly higher postoperative complication rates than controls, including septicemia, pneumonia, acute renal failure, deep wound infection, overall complications, and 30-day postoperative mortality (OR 1.41; 95% CI 1.07-1.86). The ORs of patients with low-income status were as high as 2.27 (95% CI 1.03-5.03). Preoperative use of TB drugs and TB-related medical expenditure also associated with higher postoperative mortality among surgical patients with pulmonary TB.
  
  
  CONCLUSIONS
  Surgical patients with pulmonary TB have significantly increased risks of postoperative complications and mortality after non-chest surgeries. This study suggests the need to improve postoperative care for surgical patients with pulmonary TB.
authors.affiliation: Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chi-Chen
authors.initials: CC
authors.lastname: Ke
authors.affiliation: Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chao-Shun
authors.initials: CS
authors.lastname: Lin
authors.affiliation: Department of Surgery, China Medical University Hospital, Taichung, Taiwan; Department of Surgery, University of Illinois, Chicago, United States of America.
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Yeh
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Chi-Li
authors.initials: CL
authors.lastname: Chung
authors.affiliation: Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Hung
authors.affiliation: Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Liao
authors.affiliation: Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ta-Liang
authors.initials: TL
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology*; D013624:Taiwan; D014397:Tuberculosis, Pulmonary / Q000150:complications*; D055815:Young Adult