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Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil

BACKGROUND: A diagnosis of tuberculosis (TB) does not mean that the disease will be treated successfully, since death may occur even among those who are known to the health services. Here, we aimed to analyze patient survival time from the diagnosis of TB to death, precocious deaths, and associated...

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Autores principales: dos Santos, Danielle Talita, Arroyo, Luiz Henrique, Alves, Yan Mathias, Alves, Luana Seles, Berra, Thais Zamboni, Crispim, Juliane de Almeida, Alves, Josilene Dália, Ramos, Denisse Andrea Cartagena, Alonso, Jonas Bodini, de Assis, Ivaneliza Simionato, Ramos, Antônio Vieira, Dessunti, Elma Mathias, Carvalho Pinto, Ione, Palha, Pedro Fredemir, Arcêncio, Ricardo Alexandre, Nunes, Carla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058757/
https://www.ncbi.nlm.nih.gov/pubmed/33883022
http://dx.doi.org/10.1186/s41182-021-00320-4
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author dos Santos, Danielle Talita
Arroyo, Luiz Henrique
Alves, Yan Mathias
Alves, Luana Seles
Berra, Thais Zamboni
Crispim, Juliane de Almeida
Alves, Josilene Dália
Ramos, Denisse Andrea Cartagena
Alonso, Jonas Bodini
de Assis, Ivaneliza Simionato
Ramos, Antônio Vieira
Dessunti, Elma Mathias
Carvalho Pinto, Ione
Palha, Pedro Fredemir
Arcêncio, Ricardo Alexandre
Nunes, Carla
author_facet dos Santos, Danielle Talita
Arroyo, Luiz Henrique
Alves, Yan Mathias
Alves, Luana Seles
Berra, Thais Zamboni
Crispim, Juliane de Almeida
Alves, Josilene Dália
Ramos, Denisse Andrea Cartagena
Alonso, Jonas Bodini
de Assis, Ivaneliza Simionato
Ramos, Antônio Vieira
Dessunti, Elma Mathias
Carvalho Pinto, Ione
Palha, Pedro Fredemir
Arcêncio, Ricardo Alexandre
Nunes, Carla
author_sort dos Santos, Danielle Talita
collection PubMed
description BACKGROUND: A diagnosis of tuberculosis (TB) does not mean that the disease will be treated successfully, since death may occur even among those who are known to the health services. Here, we aimed to analyze patient survival time from the diagnosis of TB to death, precocious deaths, and associated factors in southern Brazil. METHODS: We conducted a longitudinal study with patients who were diagnosed with TB and who died due to the disease between 2008 and 2015 in southern Brazil. The starting point for measuring survival time was the patient’s diagnosis date. Techniques for survival analysis were employed, including the Kaplan-Meier test and Cox’s regression. A mixed-effect model was applied for identifying the associated factors to precocious deaths. Hazard ratio (HR) and odds ratio (OR) with 95% confidence intervals (95% CI) were estimated. We defined p value <0.05 as statistically significant for all statistics applied. RESULTS: One hundred forty-six patients were included in the survival analysis, observing a median survival time of 23.5 days. We observed that alcoholism (HR=1.55, 95% CI=1.04-2.30) and being male (HR=6.49, 95% CI=1.03-2.68) were associated with death. The chance of precocious death within 60 days was 10.48 times greater than the chance of early death within 30 days. CONCLUSION: Most of the deaths occurred within 2 months after the diagnosis, during the intensive phase of the treatment. The use of alcohol and gender were associated with death, revealing inequality between men and women. This study advanced knowledge regarding the vulnerability associated with mortality. These findings must be addressed to fill a gap in the care cascades for active TB and ensure equity in health. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41182-021-00320-4.
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spelling pubmed-80587572021-04-21 Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil dos Santos, Danielle Talita Arroyo, Luiz Henrique Alves, Yan Mathias Alves, Luana Seles Berra, Thais Zamboni Crispim, Juliane de Almeida Alves, Josilene Dália Ramos, Denisse Andrea Cartagena Alonso, Jonas Bodini de Assis, Ivaneliza Simionato Ramos, Antônio Vieira Dessunti, Elma Mathias Carvalho Pinto, Ione Palha, Pedro Fredemir Arcêncio, Ricardo Alexandre Nunes, Carla Trop Med Health Research BACKGROUND: A diagnosis of tuberculosis (TB) does not mean that the disease will be treated successfully, since death may occur even among those who are known to the health services. Here, we aimed to analyze patient survival time from the diagnosis of TB to death, precocious deaths, and associated factors in southern Brazil. METHODS: We conducted a longitudinal study with patients who were diagnosed with TB and who died due to the disease between 2008 and 2015 in southern Brazil. The starting point for measuring survival time was the patient’s diagnosis date. Techniques for survival analysis were employed, including the Kaplan-Meier test and Cox’s regression. A mixed-effect model was applied for identifying the associated factors to precocious deaths. Hazard ratio (HR) and odds ratio (OR) with 95% confidence intervals (95% CI) were estimated. We defined p value <0.05 as statistically significant for all statistics applied. RESULTS: One hundred forty-six patients were included in the survival analysis, observing a median survival time of 23.5 days. We observed that alcoholism (HR=1.55, 95% CI=1.04-2.30) and being male (HR=6.49, 95% CI=1.03-2.68) were associated with death. The chance of precocious death within 60 days was 10.48 times greater than the chance of early death within 30 days. CONCLUSION: Most of the deaths occurred within 2 months after the diagnosis, during the intensive phase of the treatment. The use of alcohol and gender were associated with death, revealing inequality between men and women. This study advanced knowledge regarding the vulnerability associated with mortality. These findings must be addressed to fill a gap in the care cascades for active TB and ensure equity in health. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41182-021-00320-4. BioMed Central 2021-04-21 /pmc/articles/PMC8058757/ /pubmed/33883022 http://dx.doi.org/10.1186/s41182-021-00320-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
dos Santos, Danielle Talita
Arroyo, Luiz Henrique
Alves, Yan Mathias
Alves, Luana Seles
Berra, Thais Zamboni
Crispim, Juliane de Almeida
Alves, Josilene Dália
Ramos, Denisse Andrea Cartagena
Alonso, Jonas Bodini
de Assis, Ivaneliza Simionato
Ramos, Antônio Vieira
Dessunti, Elma Mathias
Carvalho Pinto, Ione
Palha, Pedro Fredemir
Arcêncio, Ricardo Alexandre
Nunes, Carla
Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil
title Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil
title_full Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil
title_fullStr Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil
title_full_unstemmed Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil
title_short Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil
title_sort survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern brazil
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058757/
https://www.ncbi.nlm.nih.gov/pubmed/33883022
http://dx.doi.org/10.1186/s41182-021-00320-4
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