PPM 의료기관을 방문한 결핵 사망 환자 분석

Background: Although overall incidence of tuberculosis (TB) has decreased in South Korea, it has still high mortality rate. TB mortality is one of the important indicators for TB control interventions. The purpose of this study was to identify risk factors for mortality during treatment of adult patients with pulmonary TB. Methods: A multicenter retrospective cohort study was performed at private-public mix hospitals across South Korea. Between 2015 and 2017, 3735 mortality cases of pulmonary TB were collected. All TB deaths were categorized based on cause (TB-related or non-TB-related death) and timing (early or late death). Drug-resistant TB was excluded. Results: The mean age was 74.3±13.0 years, and there were 2541 (68.0%) males. The median interval between anti-TB treatment and death was 26.0 days. There were 944 (25.3%) cases of TB-related death and 2545 (68.1%) cases of early death. Among 2791 cases of non-TB-related death, respiratory failure was the most common mode of death, followed by malignant neoplasm. In multivariate analysis, low body mass index, previously healthy individual, positive acid fast bacilli smear test result, and dyspnea were significant risk factors for both TB-related death and early death, and malignancy was a significant risk factor for both non-TB-related death and late death. Conclusion: High proportion of TB death was observed elderly patients. Majority of TB deaths were ascribed to non-TB-related causes. Early interventions identifying TB patients at high risk of death are necessary in order to reduce TB mortality.