Characteristics of tuberculosis-related deaths and risk factors: a retrospective cohort study in Samsun province of Turkey

Abstract

ABSTRACT Objectives Tuberculosis (TB) remains one of the top ten leading causes of death worldwide despite effective therapy. The present study aims to examine the characteristics of TB-related deaths in Samsun Province and to determine the risk factors. Methods In this retrospective registry-based cohort study, the medical records of patients registered with Samsun Tuberculosis Control Dispensary between 1 January 2018 and 31 December 2019 were retrospectively reviewed. The Cox proportional-hazards model was used to determine the factors associated with the risk of death in patients with TB. Results The treatment outcomes of a total of 382 patients were reviewed. It was found that the treatment was successful in 346 patients (90.6%), and 31 patients (8.1%) died before or during TB therapy. The median survival time of patients who died during the therapy was 1.86 months (95% CI = 0.07–5.17 months), and more than 50% (13/25) of the deaths occurred in the first two months of the treatment. Age above 70 years (HR 15.06 (3.33–67.95)), male gender (HR 2.74 (1.02–7.33)), pulmonary TB (HR 2.92 (1.002–8.52)), multidrug-resistant (MDR) tuberculosis (HR 1.69 (1.22–12.75)), and a delay in the treatment of more than ten days (HR 2.71 (1.22–6.04)) were identified as risk factors associated with mortality in TB patients (p < 0.05). Conclusion The majority of deaths in our cohort occurred within the first two months after starting the treatment. Advanced age, male sex, a new diagnosis of TB, pulmonary TB, MDR-TB, and a treatment delay of more than ten days after diagnosis increased the risk for mortality during antituberculosis treatment.