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Clinical Characteristics and Prognostic Analysis of Patients With Pulmonary Tuberculosis and Type 2 Diabetes Comorbidity in China: A Retrospective Analysis

Background: Tuberculosis (TB) is one of the leading communicable diseases, with significant morbidity and mortality. Diabetes can increase the risk of developing TB and the related adverse outcomes. This study retrospectively analyzed the clinical characteristics and prognosis of patients with pulmo...

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Autores principales: Zhang, Shijie, Tong, Xiang, Wang, Lei, Zhang, Tianli, Huang, Jizhen, Wang, Dongguang, Wang, Lian, Fan, Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424072/
https://www.ncbi.nlm.nih.gov/pubmed/34513785
http://dx.doi.org/10.3389/fpubh.2021.710981
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author Zhang, Shijie
Tong, Xiang
Wang, Lei
Zhang, Tianli
Huang, Jizhen
Wang, Dongguang
Wang, Lian
Fan, Hong
author_facet Zhang, Shijie
Tong, Xiang
Wang, Lei
Zhang, Tianli
Huang, Jizhen
Wang, Dongguang
Wang, Lian
Fan, Hong
author_sort Zhang, Shijie
collection PubMed
description Background: Tuberculosis (TB) is one of the leading communicable diseases, with significant morbidity and mortality. Diabetes can increase the risk of developing TB and the related adverse outcomes. This study retrospectively analyzed the clinical characteristics and prognosis of patients with pulmonary TB and type 2 diabetes comorbidity. Methods: About 282 cases with pulmonary TB and type 2 diabetes comorbidity were identified from West China Hospital between January 1, 2010, and December 31, 2016, and were followed up for at least 3 years. We further used Kaplan–Meier methods and COX regression analysis to identify the influence factors for all-cause death. Results: Compared to the survival patients, patients who died were older, exhibited significantly lower albumin and hemoglobin levels, but higher Charlson Comorbidity Index (CCI) score at admission, and had a lower usage rate of metformin. The all-cause mortality rates at 1 and 5 years were 5.67 and 20.59%, separately. For 1-year all-cause death, higher albumin level (HR = 0.90, 95% CI: 0.81–0.99) was the independently protective factor, but older age (HR = 1.07, 95% CI: 1.01–1.13) and CCI score ≥3 (HR = 6.77, 95% CI: 1.40–32.69) were the independent risk factors. For long-term all-cause death, higher albumin level (HR = 0.94, 95% CI: 0.88–1.00), the use of metformin (HR = 0.21, 95% CI: 0.07–0.59), insulin (HR = 0.27, 95% CI: 0.10–0.74), or sulfonylureas (HR = 0.23, 95% CI: 0.07–0.74) were the independently protective factors, but older age (HR = 1.03, 95% CI: 1.00–1.07) and CCI score ≥3 (HR = 7.15, 95% CI: 2.56–19.92) were the independent risk factors. Conclusions: The lower albumin level, older age, and CCI score ≥3 were predictors of all-cause death in patients with pulmonary TB and type 2 diabetes comorbidity. In the long run, patients who use metformin, insulin, or sulfonylureas as hypoglycemic agents may have a lower incidence of death.
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spelling pubmed-84240722021-09-09 Clinical Characteristics and Prognostic Analysis of Patients With Pulmonary Tuberculosis and Type 2 Diabetes Comorbidity in China: A Retrospective Analysis Zhang, Shijie Tong, Xiang Wang, Lei Zhang, Tianli Huang, Jizhen Wang, Dongguang Wang, Lian Fan, Hong Front Public Health Public Health Background: Tuberculosis (TB) is one of the leading communicable diseases, with significant morbidity and mortality. Diabetes can increase the risk of developing TB and the related adverse outcomes. This study retrospectively analyzed the clinical characteristics and prognosis of patients with pulmonary TB and type 2 diabetes comorbidity. Methods: About 282 cases with pulmonary TB and type 2 diabetes comorbidity were identified from West China Hospital between January 1, 2010, and December 31, 2016, and were followed up for at least 3 years. We further used Kaplan–Meier methods and COX regression analysis to identify the influence factors for all-cause death. Results: Compared to the survival patients, patients who died were older, exhibited significantly lower albumin and hemoglobin levels, but higher Charlson Comorbidity Index (CCI) score at admission, and had a lower usage rate of metformin. The all-cause mortality rates at 1 and 5 years were 5.67 and 20.59%, separately. For 1-year all-cause death, higher albumin level (HR = 0.90, 95% CI: 0.81–0.99) was the independently protective factor, but older age (HR = 1.07, 95% CI: 1.01–1.13) and CCI score ≥3 (HR = 6.77, 95% CI: 1.40–32.69) were the independent risk factors. For long-term all-cause death, higher albumin level (HR = 0.94, 95% CI: 0.88–1.00), the use of metformin (HR = 0.21, 95% CI: 0.07–0.59), insulin (HR = 0.27, 95% CI: 0.10–0.74), or sulfonylureas (HR = 0.23, 95% CI: 0.07–0.74) were the independently protective factors, but older age (HR = 1.03, 95% CI: 1.00–1.07) and CCI score ≥3 (HR = 7.15, 95% CI: 2.56–19.92) were the independent risk factors. Conclusions: The lower albumin level, older age, and CCI score ≥3 were predictors of all-cause death in patients with pulmonary TB and type 2 diabetes comorbidity. In the long run, patients who use metformin, insulin, or sulfonylureas as hypoglycemic agents may have a lower incidence of death. Frontiers Media S.A. 2021-08-25 /pmc/articles/PMC8424072/ /pubmed/34513785 http://dx.doi.org/10.3389/fpubh.2021.710981 Text en Copyright © 2021 Zhang, Tong, Wang, Zhang, Huang, Wang, Wang and Fan. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Zhang, Shijie
Tong, Xiang
Wang, Lei
Zhang, Tianli
Huang, Jizhen
Wang, Dongguang
Wang, Lian
Fan, Hong
Clinical Characteristics and Prognostic Analysis of Patients With Pulmonary Tuberculosis and Type 2 Diabetes Comorbidity in China: A Retrospective Analysis
title Clinical Characteristics and Prognostic Analysis of Patients With Pulmonary Tuberculosis and Type 2 Diabetes Comorbidity in China: A Retrospective Analysis
title_full Clinical Characteristics and Prognostic Analysis of Patients With Pulmonary Tuberculosis and Type 2 Diabetes Comorbidity in China: A Retrospective Analysis
title_fullStr Clinical Characteristics and Prognostic Analysis of Patients With Pulmonary Tuberculosis and Type 2 Diabetes Comorbidity in China: A Retrospective Analysis
title_full_unstemmed Clinical Characteristics and Prognostic Analysis of Patients With Pulmonary Tuberculosis and Type 2 Diabetes Comorbidity in China: A Retrospective Analysis
title_short Clinical Characteristics and Prognostic Analysis of Patients With Pulmonary Tuberculosis and Type 2 Diabetes Comorbidity in China: A Retrospective Analysis
title_sort clinical characteristics and prognostic analysis of patients with pulmonary tuberculosis and type 2 diabetes comorbidity in china: a retrospective analysis
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424072/
https://www.ncbi.nlm.nih.gov/pubmed/34513785
http://dx.doi.org/10.3389/fpubh.2021.710981
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