Factors associated with tuberculosis deaths during hospitalization in Midwest Brazil.

Abstract

Tuberculosis (TB) is a treatable disease and one of the leading causes of death worldwide, notably affecting people living with the human immunodeficiency virus. The COVID-2019 pandemic worsened TB outcomes, particularly in high-burden countries such as Brazil. Accurate data on the mortality of hospitalized patients is limited. This study aimed to evaluate clinical and epidemiological characteristics and identify mortality risk factors among all hospitalized patients with TB at a tertiary hospital in Midwest Brazil from 2017 to 2019. The median age of the 154 patients included in the study was 48 years (interquartile range: 38-59 years), and the majority were male (74.68%). The main comorbidities were diabetes mellitus and chronic obstructive pulmonary disease; 44 patients (28.57%) were admitted to the intensive care unit (ICU). The mortality rate was 33.12%, and the leading cause of death was septic shock, followed by respiratory failure due to TB. The main factors associated with death were age (p=0.001), central nervous system TB (p=0.026), reduced consciousness (p<0.001), ICU admission (p<0.001), mechanical ventilation (p<0.001), use of vasoactive drugs (VAD) (p<0.001), and duration of VAD use (p=0.038). A high rate of inpatient deaths was observed, reflecting the severity of TB and the challenges in its clinical management. It is imperative to implement strategies to reduce the mortality rate.