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背景:2003年在台湾台北市所有登记治疗的肺结核患者目的:调查研究与中断治疗至少2个月和死亡相关的危险因素方法:由就诊病历来确定肺结核患者的治疗转归。结果:在登记的1 127例肺结核患者中,824例(73.1%)治疗成功,189例(16.8%)死亡,65例(5.8%)中断治疗,17例(1.5%)已治疗15个月仍在继续治疗,32例(2.8%)治疗失败。与治疗中断显著相关的唯一因素是在开始抗结核治疗后去了其他医疗机构。结核病患者的标化死亡比率为8.7(95%可信区间为7.5～10.0)。与其他患者相比,死亡患者中与其死亡显著相关的因素有:年龄(调整风险比为1.06,95%可信区间为1.05～1.08)、未做痰培养或结果未知(调整风险比为2.07,95%可信区间为1.47～2.92)、合并呼吸系统疾病(调整风险比为1.68,95%可信区间为1.24～2.27),合并感染性疾病(调整风险比为2.80,95%可信区间为2.07～3.78),合并肾脏疾病(调整风险比为2.58,95%可信区间为1.82～3.66)或合并癌症(调整风险比为3.31,95%可信区间为2.35～4.65)。结论:到其他医疗机构就诊是与中断治疗至少2个月相关的因素。高死亡比例是由于年龄大和合并症。
Background: All TB patients enrolled for treatment in Taipei, Taiwan in 2003 Objective: To investigate and discontinue at least 2 months risk factors related to death Methods of treatment: To determine the treatment outcome of TB patients from the medical records. RESULTS: Of the 1 127 registered tuberculosis patients, 824 (73.1%) were successfully treated, 189 (16.8%) died, 65 (5.8%) were discontinued and 17 (1.5%) were treated for 15 months In continuing treatment, 32 patients (2.8%) failed treatment. The only factor that was significantly associated with discontinuation of treatment was to go to other healthcare facilities after starting anti-TB treatment. The standardized death rate for tuberculosis patients was 8.7 (95% confidence interval 7.5 to 10.0). Significantly related to death among those who died compared with other patients were age (adjusted risk ratio, 1.06; 95% confidence interval, 1.05 to 1.08), no sputum culture or unknown outcome (adjusted risk ratio, 2.07, 95% confidence interval was 1.47 to 2.92), combined with respiratory diseases (adjusted risk ratio 1.68, 95% confidence interval 1.24 to 2.27), combined with infectious disease (adjusted risk ratio 2.80, 95% confidence interval 2.07 to 3.78), with renal disease (adjusted risk ratio, 2.58, 95% confidence interval, 1.82 to 3.66) or combined cancer (adjusted risk ratio, 3.31, 95% confidence interval, 2.35 to 4.65). Conclusions: Visits to other healthcare facilities are associated with discontinuation of treatment for at least 2 months. The high death rate is due to age and comorbidities.