Association between sputum conversion and in-hospital mortality in elderly patients with pulmonary tuberculosis: a retrospective study
Abstract Background Non-conversion of sputum culture or smear within 2 months after the start of treatment is a known poor prognostic factor of pulmonary tuberculosis. In elderly patients, sputum conversion may be delayed because of the age-related decline in immune competence. This study aimed to a...
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-022-07334-1 |
| _version_ | 1811272615733493760 |
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| author | Yuta Nakamura Mari Yamasue Kosaku Komiya Shuichi Takikawa Kazufumi Hiramatsu Jun-ichi Kadota |
| author_facet | Yuta Nakamura Mari Yamasue Kosaku Komiya Shuichi Takikawa Kazufumi Hiramatsu Jun-ichi Kadota |
| author_sort | Yuta Nakamura |
| collection | DOAJ |
| description | Abstract Background Non-conversion of sputum culture or smear within 2 months after the start of treatment is a known poor prognostic factor of pulmonary tuberculosis. In elderly patients, sputum conversion may be delayed because of the age-related decline in immune competence. This study aimed to assess how a long interval to sputum conversion predicts in-hospital mortality in elderly patients with pulmonary tuberculosis. Methods Consecutive elderly patients (age > 65 years) who were admitted to our institution for bacteriologically confirmed pulmonary tuberculosis were included. The association between sputum conversion within 30, 60, 90, or 120 days from the start of treatment and in-hospital mortality were analyzed by Cox proportional-hazards regression after adjustment for other potential variables. Results This study included 262 patients, and 74 patients (28%) died during hospitalization. Multivariate analyses showed that sputum non-conversion within 90 days (adjusted hazard ratio 0.424, 95% CI 0.252–0.712, p = 0.001) or 120 days (0.333, 0.195–0.570, p < 0.001) was independently associated with in-hospital mortality, whereas that within 60 days was not (p = 0.890). Conclusions In elderly patients with tuberculosis, 2 months may be insufficient when evaluating sputum conversion as a prognostic factor. Sputum non-conversion within 90 days or longer may predict in-hospital mortality more accurately. |
| first_indexed | 2024-04-12T22:43:32Z |
| format | Article |
| id | doaj.art-3f3f133225a9492789f4f5fec2fcbf70 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-12T22:43:32Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-3f3f133225a9492789f4f5fec2fcbf702022-12-22T03:13:37ZengBMCBMC Infectious Diseases1471-23342022-04-012211710.1186/s12879-022-07334-1Association between sputum conversion and in-hospital mortality in elderly patients with pulmonary tuberculosis: a retrospective studyYuta Nakamura0Mari Yamasue1Kosaku Komiya2Shuichi Takikawa3Kazufumi Hiramatsu4Jun-ichi Kadota5Internal Medicine, National Hospital Organization Nishi-Beppu HospitalInternal Medicine, National Hospital Organization Nishi-Beppu HospitalInternal Medicine, National Hospital Organization Nishi-Beppu HospitalInternal Medicine, National Hospital Organization Nishi-Beppu HospitalRespiratory Medicine and Infectious Diseases, Oita University Faculty of MedicineRespiratory Medicine and Infectious Diseases, Oita University Faculty of MedicineAbstract Background Non-conversion of sputum culture or smear within 2 months after the start of treatment is a known poor prognostic factor of pulmonary tuberculosis. In elderly patients, sputum conversion may be delayed because of the age-related decline in immune competence. This study aimed to assess how a long interval to sputum conversion predicts in-hospital mortality in elderly patients with pulmonary tuberculosis. Methods Consecutive elderly patients (age > 65 years) who were admitted to our institution for bacteriologically confirmed pulmonary tuberculosis were included. The association between sputum conversion within 30, 60, 90, or 120 days from the start of treatment and in-hospital mortality were analyzed by Cox proportional-hazards regression after adjustment for other potential variables. Results This study included 262 patients, and 74 patients (28%) died during hospitalization. Multivariate analyses showed that sputum non-conversion within 90 days (adjusted hazard ratio 0.424, 95% CI 0.252–0.712, p = 0.001) or 120 days (0.333, 0.195–0.570, p < 0.001) was independently associated with in-hospital mortality, whereas that within 60 days was not (p = 0.890). Conclusions In elderly patients with tuberculosis, 2 months may be insufficient when evaluating sputum conversion as a prognostic factor. Sputum non-conversion within 90 days or longer may predict in-hospital mortality more accurately.https://doi.org/10.1186/s12879-022-07334-1TuberculosisConversionElderlyMortality |
| spellingShingle | Yuta Nakamura Mari Yamasue Kosaku Komiya Shuichi Takikawa Kazufumi Hiramatsu Jun-ichi Kadota Association between sputum conversion and in-hospital mortality in elderly patients with pulmonary tuberculosis: a retrospective study BMC Infectious Diseases Tuberculosis Conversion Elderly Mortality |
| title | Association between sputum conversion and in-hospital mortality in elderly patients with pulmonary tuberculosis: a retrospective study |
| title_full | Association between sputum conversion and in-hospital mortality in elderly patients with pulmonary tuberculosis: a retrospective study |
| title_fullStr | Association between sputum conversion and in-hospital mortality in elderly patients with pulmonary tuberculosis: a retrospective study |
| title_full_unstemmed | Association between sputum conversion and in-hospital mortality in elderly patients with pulmonary tuberculosis: a retrospective study |
| title_short | Association between sputum conversion and in-hospital mortality in elderly patients with pulmonary tuberculosis: a retrospective study |
| title_sort | association between sputum conversion and in hospital mortality in elderly patients with pulmonary tuberculosis a retrospective study |
| topic | Tuberculosis Conversion Elderly Mortality |
| url | https://doi.org/10.1186/s12879-022-07334-1 |
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