Skip to main content Accessibility help
×
Home

Determinants of mortality in elderly patients with tuberculosis: a population-based follow-up study

  • Y.-F. YEN (a1) (a2) (a3), J.-Y. FENG (a2) (a4), S.-W. PAN (a2) (a4), P.-H. CHUANG (a5) (a6), V. Y.-F. SU (a7) (a8) and W.-J. SU (a2) (a4)...

Summary

Elderly individuals with tuberculosis (TB) are more likely to have a non-specific clinical presentation of TB and high mortality. However, factors associated with mortality in elderly TB patients have not been extensively studied. This retrospective cohort study aimed to identify factors associated with death among elderly Taiwanese with TB. All elderly patients with TB from 2006 to 2014 in Taipei, Taiwan, were included in a study. Multiple logistic regression was used to identify the factors associated with death in elderly TB patients. The mean age of the 5011 patients was 79·7 years; 74·1% were men; 32·7% had mortality during the study follow-up period. After controlling for potential confounders, age ⩾75 years (reference: 65–74 years), male sex, end-stage renal disease (ESRD), malignancy, acid-fast bacilli-smear positivity, TB-culture positivity, pleural effusion on chest radiograph and notification by an ordinary ward or intensive care unit were associated with a higher risk of all-cause death; while high school, and university or higher education, cavity on chest radiograph and directly observed therapy were associated with a lower risk of all-cause death. This study found that the proportion of death among elderly patients with TB in Taipei, Taiwan, was high. To improve TB treatment outcomes, future control programmes should particularly target individuals with comorbidities (e.g. ESRD and malignancy) and those with a lower socio-economic status (e.g. not educated).

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Determinants of mortality in elderly patients with tuberculosis: a population-based follow-up study
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Determinants of mortality in elderly patients with tuberculosis: a population-based follow-up study
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Determinants of mortality in elderly patients with tuberculosis: a population-based follow-up study
      Available formats
      ×

Copyright

Corresponding author

*Author for correspondence: W.-J. Su, MD, MPH, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China (Email: wjsu@vghtpe.gov.tw)

References

Hide All
1. World Health Organization (2014) Global tuberculosis control. WHO report 2014. (http://www.who.int/tb/publications/global_report/gtbr15_main_text.pdf). Accessed 20 September 2016.
2. Taiwan Centers for Disease Control and Prevention (2016) [Promulgated definitions of TB]. Taipei, Taiwan: CDC. (http://nidss.cdc.gov.tw/singledisease.aspx?pt=s&dc=1&dt=3&disease=010) Accessed 16 September 2016. [Chinese].
3. Yen, YF, et al. Risk factors for unfavorable outcome of pulmonary tuberculosis in adults in Taipei, Taiwan. Transactions of the Royal Society of Tropical Medicine and Hygiene 2012; 106: 303308.
4. Cruz-Hervert, LP, et al. Tuberculosis in ageing: high rates, complex diagnosis and poor clinical outcomes. Age and Ageing 2012; 41: 488495.
5. Byng-Maddick, R, et al. Does tuberculosis threaten our ageing populations? BMC Infectious Diseases 2016; 16: 119.
6. Morris, CD. Pulmonary tuberculosis in the elderly: a different disease? Thorax 1990; 45: 912913.
7. Schaaf, HS, et al. Tuberculosis at extremes of age. Respirology 2010; 15: 747763.
8. Balabanova, Y, et al. The Directly Observed Therapy Short-Course (DOTS) strategy in Samara Oblast, Russian Federation. Respiratory Research 2006; 7: 44.
9. Department of Health. Vital Statistics in Taiwan. Taiwan: Department of Health, Executive Yuan, 1971.
10. Waitt, CJ, et al. A systematic review of risk factors for death in adults during and after tuberculosis treatment. International Journal of Tuberculosis and Lung Disease 2011; 15: 871885.
11. Jasmer, RM, et al. Tuberculosis treatment outcomes: directly observed therapy compared with self-administered therapy. American Journal of Respiratory and Critical Care Medicine 2004; 170: 561566.
12. Ministry of Health and Welfare. Vital Statistics in Taiwan. Taiwan: Ministry of Health and Welfare, Executive Yuan. (http://www.mohw.gov.tw/CHT/DOS/Statistic.aspx?f_list_no=312&fod_list_no=1601). Accessed 16 December 2016. [Chinese].
13. Storla, DG, et al. A systematic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health 2008; 8: 15.
14. Younis, MZ, et al. The impact of HMO and hospital competition on hospital costs. Journal of Health Care Finance 2005; 31: 6074.
15. Hoa, NP, et al. Knowledge about tuberculosis and its treatment among new pulmonary TB patients in the north and central regions of Vietnam. International Journal of Tuberculosis and Lung Disease 2004; 8: 603608.
16. Elzinga, G, et al. Scale up: meeting targets in global tuberculosis control. Lancet 2004; 363: 814819.
17. Okanurak, K, et al. Factors contributing to treatment success among tuberculosis patients: a prospective cohort study in Bangkok. International Journal of Tuberculosis and Lung Disease 2008; 12: 11601165.
18. Lin, HP, et al. Diagnosis and treatment delay among pulmonary tuberculosis patients identified using the Taiwan reporting enquiry system, 2002–2006. BMC Public Health 2009; 9: 55.
19. Chiang, CY, et al. Patient and health system delays in the diagnosis and treatment of tuberculosis in Southern Taiwan. International Journal of Tuberculosis and Lung Disease 2005; 9: 10061012.
20. Hopewell, PC, et al. International standards for tuberculosis care. Lancet Infect Dis 2006; 6: 710725.
21. Frieden, TR, et al. Promoting adherence to treatment for tuberculosis: the importance of direct observation. Bulletin of the World Health Organization 2007; 85: 407409.
22. Yen, YF, et al. Association of body mass index with tuberculosis mortality: a population-based follow-up study. Medicine (Baltimore) 2016; 95: e2300.
23. Yen, YF, et al. DOT associated with reduced all-cause mortality among tuberculosis patients in Taipei, Taiwan, 2006–2008. International Journal of Tuberculosis and Lung Disease 2012; 16: 178184.
24. Kliiman, K, et al. Predictors and mortality associated with treatment default in pulmonary tuberculosis. International Journal of Tuberculosis and Lung Disease 2010; 14: 454463.
25. Pepper, DJ, et al. Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa. PLoS ONE 2011; 6: e19484.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed