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Risk factors for poor tuberculosis treatment outcome in Finland: a cohort study
BACKGROUND: We investigated the patient- and treatment-system dependent factors affecting treatment outcome in a two-year cohort of all treated culture-verified pulmonary tuberculosis (TB) cases to establish a basis for improving outcomes. METHODS: Medical records of all cases in 1995 – 1996 were ab...
Autores principales: | , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2007
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2099439/ https://www.ncbi.nlm.nih.gov/pubmed/17935630 http://dx.doi.org/10.1186/1471-2458-7-291 |
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author | Vasankari, Tuula Holmström, Pekka Ollgren, Jukka Liippo, Kari Kokki, Maarit Ruutu, Petri |
author_facet | Vasankari, Tuula Holmström, Pekka Ollgren, Jukka Liippo, Kari Kokki, Maarit Ruutu, Petri |
author_sort | Vasankari, Tuula |
collection | PubMed |
description | BACKGROUND: We investigated the patient- and treatment-system dependent factors affecting treatment outcome in a two-year cohort of all treated culture-verified pulmonary tuberculosis (TB) cases to establish a basis for improving outcomes. METHODS: Medical records of all cases in 1995 – 1996 were abstracted to assess outcome of treatment. Outcome was divided into three groups: favourable, death and other unfavourable. Predictors of unfavourable outcome were assessed in univariate and multivariate analysis. RESULTS: Among 629 cases a favourable outcome was achieved in 441 (70.1%), 17.2% (108) died and other unfavourable outcome took place in 12.7% (80). Significant independent risk factors for death were male sex, high age, non-HIV -related immunosuppression and any other than a pulmonary specialty being responsible for stopping treatment. History of previous tuberculosis was inversely associated with the risk of death. For other unfavourable treatment outcomes, significant risk factors were pause(s) in treatment, treatment with INH+RIF+EMB/SM, and internal medicine specialty being responsible at the end of the treatment. CONCLUSION: We observed a significant association with unfavourable outcome for the specialty responsible for treatment being other than pulmonary, but not for the volume of cases, which has implications for system arrangements. Poor outcomes associated with immunosuppression and advanced age, with frequent comorbidity, stress a low threshold of suspicion, availability of rapid diagnostics, and early empiric treatment as probable approaches in attempting to improve treatment outcomes in countries with very low incidence of TB. |
format | Text |
id | pubmed-2099439 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2007 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-20994392007-11-30 Risk factors for poor tuberculosis treatment outcome in Finland: a cohort study Vasankari, Tuula Holmström, Pekka Ollgren, Jukka Liippo, Kari Kokki, Maarit Ruutu, Petri BMC Public Health Research Article BACKGROUND: We investigated the patient- and treatment-system dependent factors affecting treatment outcome in a two-year cohort of all treated culture-verified pulmonary tuberculosis (TB) cases to establish a basis for improving outcomes. METHODS: Medical records of all cases in 1995 – 1996 were abstracted to assess outcome of treatment. Outcome was divided into three groups: favourable, death and other unfavourable. Predictors of unfavourable outcome were assessed in univariate and multivariate analysis. RESULTS: Among 629 cases a favourable outcome was achieved in 441 (70.1%), 17.2% (108) died and other unfavourable outcome took place in 12.7% (80). Significant independent risk factors for death were male sex, high age, non-HIV -related immunosuppression and any other than a pulmonary specialty being responsible for stopping treatment. History of previous tuberculosis was inversely associated with the risk of death. For other unfavourable treatment outcomes, significant risk factors were pause(s) in treatment, treatment with INH+RIF+EMB/SM, and internal medicine specialty being responsible at the end of the treatment. CONCLUSION: We observed a significant association with unfavourable outcome for the specialty responsible for treatment being other than pulmonary, but not for the volume of cases, which has implications for system arrangements. Poor outcomes associated with immunosuppression and advanced age, with frequent comorbidity, stress a low threshold of suspicion, availability of rapid diagnostics, and early empiric treatment as probable approaches in attempting to improve treatment outcomes in countries with very low incidence of TB. BioMed Central 2007-10-14 /pmc/articles/PMC2099439/ /pubmed/17935630 http://dx.doi.org/10.1186/1471-2458-7-291 Text en Copyright © 2007 Vasankari et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Vasankari, Tuula Holmström, Pekka Ollgren, Jukka Liippo, Kari Kokki, Maarit Ruutu, Petri Risk factors for poor tuberculosis treatment outcome in Finland: a cohort study |
title | Risk factors for poor tuberculosis treatment outcome in Finland: a cohort study |
title_full | Risk factors for poor tuberculosis treatment outcome in Finland: a cohort study |
title_fullStr | Risk factors for poor tuberculosis treatment outcome in Finland: a cohort study |
title_full_unstemmed | Risk factors for poor tuberculosis treatment outcome in Finland: a cohort study |
title_short | Risk factors for poor tuberculosis treatment outcome in Finland: a cohort study |
title_sort | risk factors for poor tuberculosis treatment outcome in finland: a cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2099439/ https://www.ncbi.nlm.nih.gov/pubmed/17935630 http://dx.doi.org/10.1186/1471-2458-7-291 |
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