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. 2017 May/Jun;132(3):366-375.
doi: 10.1177/0033354917698117. Epub 2017 Apr 10.

Sociodemographic and Clinical Risk Factors Associated With Tuberculosis Mortality in the United States, 2009-2013

Haylea A Hannah  1 , Roque Miramontes  2 , Neel R Gandhi  1
Affiliations

Sociodemographic and Clinical Risk Factors Associated With Tuberculosis Mortality in the United States, 2009-2013

Haylea A Hannah et al. Public Health Rep. 2017 May/Jun.

Abstract

Objectives: The objectives of our study were (1) to determine risk factors associated with tuberculosis (TB)-specific and non-TB-specific mortality among patients with TB and (2) to examine whether risk factors for TB-specific mortality differed from those for non-TB-specific mortality.

Methods: We obtained data from the National Tuberculosis Surveillance System and included all patients who had TB between 2009 and 2013 in the United States and its territories. We used multinomial logistic regression analysis to determine the adjusted odds ratio (aOR) of each risk factor for TB-specific and non-TB-specific mortality.

Results: Of 52 175 eligible patients with TB, 1404 died from TB, and 2413 died from other causes. Some of the risk factors associated with the highest odds of TB-specific mortality were multidrug-resistant TB diagnosis (aOR = 3.42; 95% CI, 1.95-5.99), end-stage renal disease (aOR = 3.02; 95% CI, 2.23-4.08), human immunodeficiency virus infection (aOR = 2.63; 95% CI, 2.02-3.42), age 45-64 years (aOR = 2.57; 95% CI, 2.01-3.30) or age ≥65 years (aOR = 5.76; 95% CI, 4.37-7.61), and immunosuppression (aOR = 2.20; 95% CI, 1.71-2.83). All of these risk factors except multidrug-resistant TB were also associated with increased odds of non-TB-specific mortality.

Conclusion: TB patients with certain risk factors have an elevated risk of TB-specific mortality and should be monitored before, during, and after treatment. Identifying the predictors of TB-specific mortality may help public health authorities determine which subpopulations to target and where to allocate resources.

Keywords: mortality; surveillance; tuberculosis.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure.
Figure.
Flow diagram for 52 175 patients with tuberculosis (TB) in the United States reported to the National Tuberculosis Surveillance System between 2009 and 2013 and included in an analysis of the risk factors associated with TB-specific mortality and non–TB-specific mortality. Non–TB-specific mortality includes only patients for whom the cause of death was explicitly recorded as not due to TB. TB patients who died during therapy included patients for whom the cause of death was due to TB therapy, unrelated, or unknown.
See this image and copyright information in PMC

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