Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil

Tropical Medicine and Health

Denisse Andrea Cartagena Ramos¹  Juliane de Almeida Crispim²  Carla Nunes³  Josilene Dália Alves⁴  Pedro Fredemir Palha⁵  Antônio Vieira Ramos⁵  Yan Mathias Alves⁵  Ione Carvalho Pinto⁵  Luana Seles Alves⁵  Thais Zamboni Berra⁵  Danielle Talita dos Santos⁶  Luiz Henrique Arroyo⁶  Jonas Bodini Alonso⁶  Ricardo Alexandre Arcêncio⁶  Elma Mathias Dessunti⁷  Ivaneliza Simionato de Assis⁸ 

[1] Facultad de Enfermería, Universidade Andrés Bello, Santiago, Chile;Inter-institucional Doctoral Program in Nursing, Ribeirão Preto College of Nursing at University of São Paulo, Ribeirão Preto, São Paulo, Brazil;NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal;Nursing Department, Federal University of Mato Grosso, Barra do Garças, Cuiabá, Brazil;Postgraduate in the Public Health Nursing Program, Ribeirão Preto College of Nursing at University of São Paulo, Ribeirão Preto, São Paulo, Brazil;Ribeirão Preto College of Nursing (EERP/USP), University of São Paulo, Avenida dos Bandeirantes, 3900, Monte Alegre, 14040-902, Ribeirão Preto, São Paulo, Brazil;State University of Londrina, Londrina, Brazil;University Center Dinâmica of Cataratas (UDC), Foz do Iguazu, Paraná, Brazil;

关键词: Survival analysis;    Tuberculosis;    HIV;    Mortality;    Risk factors;   

DOI  :  10.1186/s41182-021-00320-4

来源: Springer

【 摘 要 】

BackgroundA diagnosis of tuberculosis (TB) does not mean that the disease will be treated successfully, since death may occur even among those who are known to the health services. Here, we aimed to analyze patient survival time from the diagnosis of TB to death, precocious deaths, and associated factors in southern Brazil.MethodsWe conducted a longitudinal study with patients who were diagnosed with TB and who died due to the disease between 2008 and 2015 in southern Brazil. The starting point for measuring survival time was the patient’s diagnosis date. Techniques for survival analysis were employed, including the Kaplan-Meier test and Cox’s regression. A mixed-effect model was applied for identifying the associated factors to precocious deaths. Hazard ratio (HR) and odds ratio (OR) with 95% confidence intervals (95% CI) were estimated. We defined p value <0.05 as statistically significant for all statistics applied.ResultsOne hundred forty-six patients were included in the survival analysis, observing a median survival time of 23.5 days. We observed that alcoholism (HR=1.55, 95% CI=1.04-2.30) and being male (HR=6.49, 95% CI=1.03-2.68) were associated with death. The chance of precocious death within 60 days was 10.48 times greater than the chance of early death within 30 days.ConclusionMost of the deaths occurred within 2 months after the diagnosis, during the intensive phase of the treatment. The use of alcohol and gender were associated with death, revealing inequality between men and women. This study advanced knowledge regarding the vulnerability associated with mortality. These findings must be addressed to fill a gap in the care cascades for active TB and ensure equity in health.

【 授权许可】

CC BY