中国城市居民结核病死亡率的决定因素：一项基于医院的队列研究

IF 2.3 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2025-01-22 DOI:10.1016/j.cegh.2025.101934

Shu-jin Ruan , Zhi Liu , Zhi Mao , Ting Meng , Jian Li , Xue Ke , Xu-hui Liu , Guo-bao Li , Jing-fang Chen , Xiu-fen Wang

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引用次数: 0

摘要

背景与目标为实现到2035年结核病死亡率较2015年降低95%的目标，不同地区可能有必要针对各自的结核病死亡率组成部分制定具体的干预策略。本研究旨在调查中国发达城市结核病患者的死亡原因。方法回顾性队列研究纳入2017 - 2022年在深圳市最大的结核病定点医院登记的8851例结核病患者。对主要死亡原因进行分类，并使用多变量逻辑回归来确定结核病死亡的独立危险因素。结果在治疗期间，结核病死亡率为1.6%。结核病死亡率的独立危险因素包括男性、年龄较大、较低的身体质量指数（BMI）、贫血和肿瘤的存在。值得注意的是，即使在资源充足的城市环境中，治疗依从性差也是死亡率的重要因素。此外，慢性疾病的进展成为结核病相关死亡的一个关键因素，特别是在有严重基础疾病的患者中。结论：本研究强调了解决治疗依从性和医疗可及性问题对于降低结核病死亡率的重要性，即使在医疗基础设施健全的城市环境中也是如此。研究结果还强调需要对结核病和慢性病进行综合管理，以及早期发现和管理潜在疾病，以改善患者的预后。这些见解对于制定有针对性的干预措施至关重要，这些干预措施可以在类似的城市人群中加强结核病治疗并降低死亡率。

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Determinants of tuberculosis mortality in an urban residents: A hospital-based cohort study in China

Background and objectives

To reach the goal of a 95 % reduction in Tuberculosis (TB) mortality by 2035 compared to 2015, it may be necessary for different regions to create specific intervention strategies tailored to their respective TB mortality components. This study aimed to investigate the causes of death among TB patients in China's developed cities.

Methods

This retrospective cohort study included 8851TB patients registered at Shenzhen's largest TB-designated hospital between 2017 and 2022. The primary causes of death were categorized, and multivariable logistic regression was used to identify independent risk factors for TB mortality.

Results

The study revealed a TB mortality rate of 1.6 % during the treatment period. Independent risk factors for TB mortality included male gender, older age, lower body mass index (BMI), anemia, and the presence of tumors. Notably, poor treatment adherence was significant contributors to mortality, even in this well-resourced urban environment. Additionally, the progression of the chronic disease emerged as a critical factor in TB-related deaths, particularly among patients with severe underlying conditions.

Conclusion

This study underscores the importance of addressing treatment adherence and healthcare accessibility to reduce TB mortality, even in urban settings with robust healthcare infrastructure. The findings also highlight the need for integrated management of TB and chronic diseases, as well as early identification and management of underlying disease to improve patient outcomes. These insights are crucial for developing targeted interventions that can enhance TB care and reduce mortality in similar urban populations.

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.