title: Retrospective cohort evaluation on risk of pneumonia in patients with pulmonary tuberculosis.
abstract: Pulmonary tuberculosis (PTb) and pneumonia are diseases that may exist concomitantly. Population study investigating the subsequent pneumonia development in PTb patients is limited. This study compares the risk of pneumonia between cohorts with and without PTb.We used the claims data of the Taiwan National Health Insurance to identify a cohort with PTb (N = 3417) newly diagnosed in 2000-2006 without pneumonia history, and a randomly selected comparison cohort (N = 6834) free of PTb and pneumonia, frequency matched by propensity score. Incidence rates and hazard ratios of pneumonia were calculated by sex, age, and comorbidity starting in the 7th month after the cohorts being established until the end of 2011.We found the incidence of pneumonia to be 1.9-fold higher in the PTb cohort than in the PTb free cohort (51.6 vs 27.0 per 1000 person-years). The PTb cohort had a Cox method estimated adjusted hazard ratio of 2.14 (95% confidence interval = 1.96-2.32). We also found that the risk was greater for men than for women, but lower for young adults aged 20-39 years. Comorbidity interacted with PTb by aggravating the pneumonia risk, particularly for those with asthma. For PTb patients comorbid with asthma, the pneumonia incidence was 2.5-fold higher than for PTb patients free of comorbidities (75.9 vs 29.3 per 1000 person-years).Our results display that PTb patients have an elevated risk of developing pneumonia. Adequate follow-up should be provided to the PTb patients, especially those with comorbidity.
authors.affiliation: aDepartment of Public Health, China Medical University bDepartment of Nursing, Central Taiwan University of Science and Technology cManagement Office for Health Data, China Medical University Hospital dGraduate Institute of Clinical Medicine Science, College of Medicine, China Medical University eDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung fDepartment of Laboratory Medicine, Hsin-Chu Mackay Memorial Hospital gDepartment of Laboratory Medicine, Catholic Mercy Hospital, Catholic Mercy Medical Foundation, HsinChu hDepartment of Health Services Administration, China Medical University, Taichung, Taiwan iMahidol University Faculty of Public Health, Bangkok, Thailand.
authors.forename: Tsui-Ming
authors.initials: TM
authors.lastname: Chang
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Mou
authors.forename: Te-Chun
authors.initials: TC
authors.lastname: Shen
authors.forename: Chien-Lung
authors.initials: CL
authors.lastname: Yang
authors.forename: Min-Hui
authors.initials: MH
authors.lastname: Yang
authors.forename: Fang-Yang
authors.initials: FY
authors.lastname: Wu
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D014397:Tuberculosis, Pulmonary / Q000150:complications*; D055815:Young Adult