Risk factors for death among hospitalised tuberculosis patients in poor urban areas in Manila, The PhilippinesRisk factors for death among hospitalised tuberculosis patients in poor urban areas in Manila, The Philippines フィリピンマニラ貧困地区の病院に入院した結核患者の死亡危険因子に関する研究
1426 , 2015-03-20 , The Union
OBJECTIVE: To determine the mortality rate and risk factors for in-hospital death among hospitalised human immunodeficiency virus (HIV) negative tuberculosis (TB) patients in poor urban areas in the Philippines.
DESIGN: A cross-sectional study was conducted at a national infectious disease hospital in Manila City. The target population was patients aged ≥13 years with all forms of HIV-negative TB admitted from October to December 2009. Demographic and clinical information was collected from medical charts, and risk of in-hospital death was measured.
RESULTS: Of 407 HIV-negative TB patients, four were excluded due to missing records, and 403 were included in the analysis. The majority were poor urban residents (90%), and 66% were males. Overall, 37.5% of hospitalised patients died in the hospital (151/403), 30% of whom died before the third day of hospitalisation. Risk factor analysis demonstrated that complications of bacterial pneumonia had the greatest effect on in-hospital death (aOR 4.53, 95%CI 2.65–7.72), followed by anorexia (aOR 3.01, 95%CI 1.55–5.84), anaemia (haemoglobin <10 g/dl, aOR 2.35, 95%CI 1.34–4.13) and older age (aged ≥50 years, aOR 1.85, 95%CI 1.08–3.17). The presence of haemoptysis (aOR 0.44, 95%CI 0.25–0.80) was associated with improved survival.
CONCLUSION: Mortality among hospitalised HIV-negative TB patients was extremely high in poor urban areas in the Philippines.