Disagreement on estimating cause of death under tuberculosis treatment between the national tuberculosis registry and statistics data in South Korea, 2011–2020

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-02-26 DOI:10.1016/j.jiph.2025.102723

Chiwook Chung , Seung Won Lee , Dawoon Jeong , Hongjo Choi , Hojoon Sohn , Doosoo Jeon , Young Ae Kang

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Abstract

Background

Disagreement persists regarding the cause of death in patients with tuberculosis (TB) between the national TB registry and vital registration statistics. This study investigated the disagreement and contributing factors between TB-related and non-TB-related deaths using an integrated national TB database in South Korea.

Methods

We identified a sub-set cohort of 29,033 patients with drug-susceptible TB registered between 2011 and 2020 who died during TB treatment. The cause of death was identified by the Korean National Tuberculosis Surveillance System (KNTSS) and Statistics Korea database. We performed a multinomial logistic regression to identify factors associated with the cause of death.

Results

The participants’ median age was 79 years (interquartile range, 70–85 years), with males comprising 63.2 %. Among the 29,033 deaths, 12,937 (44.6 %) and 6028 (20.8 %) were classified as TB-related deaths in Statistics Korea and KNTSS, respectively. The overall agreement rate for the cause of death between the two databases was 0.72 (95 % confidence interval, 0.71–0.72), increasing from 0.69 in 2011–0.77 in 2020. Among discrepant cases, 92.2 % (7545/8181) were classified as non-TB-related in KNTSS but as TB-related in Statistics Korea. Over the study period, the proportion of individuals classified as non-TB-related deaths in both databases and the agreement rate increased. In the multinomial analysis, age, sputum acid-fast bacilli smear, Charlson comorbidity index, and comorbidities, such as cancer and end-stage renal disease, showed distinguishing features across the cause of death groups.

Conclusions

Substantial disagreement on the cause of death persists between the national TB registry and vital registration statistics, though this decreased during the study period. Most disagreement likely indicates an underestimation of TB-related deaths in the TB registry. Age, sputum smear, and comorbidities were identifiable characteristics across groups that may influence the cause of death coding process.

查看原文本刊更多论文

2011-2020年韩国国家结核病登记和统计数据在估计结核病治疗下死亡原因方面存在分歧

背景：国家结核病登记和生命登记统计数据之间关于结核病（TB）患者死亡原因的分歧仍然存在。本研究利用韩国的综合国家结核病数据库调查了结核病相关和非结核病相关死亡之间的差异和影响因素。方法：我们确定了2011年至2020年期间登记的29,033例药敏结核病患者的亚组队列，这些患者在结核病治疗期间死亡。死亡原因由韩国国家结核病监测系统（KNTSS）和韩国统计局数据库确定。我们进行了多项逻辑回归来确定与死亡原因相关的因素。结果参与者年龄中位数为79岁（四分位数范围为70-85岁），男性占63.2% %。在29033名死亡者中，统计厅和KNTSS分别将12937人（44.6% %）和6028人（20.8% %）归类为结核病相关死亡者。两个数据库之间死亡原因的总体一致性率为0.72(95 %置信区间，0.71-0.72)，高于2011年的0.69（2020年为0.77）。其中，92.2 %（7545/8181）的患者在KNTSS中属于非结核相关，但在统计厅中属于结核相关。在研究期间，在两个数据库中被归类为非结核病相关死亡的个人比例和一致性率都有所增加。在多项分析中，年龄、痰抗酸杆菌涂片、Charlson合病指数和合病，如癌症和终末期肾脏疾病，在不同的死亡原因组中表现出明显的特征。结论：在国家结核病登记和生命登记统计数据之间，死亡原因存在重大分歧，尽管在研究期间这种分歧有所减少。大多数分歧可能表明结核病登记中与结核病有关的死亡人数被低估了。年龄、痰涂片和合并症是各组中可识别的特征，可能会影响死亡原因编码过程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.