TY - JOUR
T1 - Mortality, risk factors, and causes of death among people with tuberculosis in Denmark, 1990 - 2018
AU - Nordholm, Anne Christine
AU - Andersen, Aase Bengaard
AU - Wejse, Christian
AU - Norman, Anders
AU - Ekstrøm, Claus Thorn
AU - Andersen, Peter Henrik
AU - Lillebaek, Troels
AU - Koch, Anders
N1 - Copyright © 2023. Published by Elsevier Ltd.
PY - 2023/5
Y1 - 2023/5
N2 - OBJECTIVES: This study aimed to analyze mortality, risk factors, and causes of death among people with tuberculosis (TB).METHODS: This is a population-based cohort study with patients with TB ≥18 years notified from 1990 to 2018 in Denmark, compared with sex- and age-matched controls. Mortality was assessed in Kaplan-Meier models and risk factors for death were estimated in Cox proportional hazards models.RESULTS: Overall mortality was twofold higher among people with TB compared with controls up to 15 years after TB diagnosis (hazard ratio [HR]: 2.18, 95% confidence interval [CI]: 2.06-2.29, P <0.0001). Danes with TB were three times more likely to die than migrants (adjusted HR: 3.13, 95% CI: 2.84-3.45, P <0.0001). Risk factors for death included living alone, being unemployed, having low income, and comorbidities such as mental illness with substance abuse, lung diseases, hepatitis, and HIV. TB was the most common cause of death (21%), followed by chronic obstructive pulmonary disease (7%), lung cancer (6%), alcoholic liver disease (5%), and mental illness with substance abuse (4%).CONCLUSION: People with TB had substantially inferior survival up to 15 years after TB diagnosis, in particular, socially disadvantaged Danes with TB with specific comorbidities. This may reflect unmet needs for enhanced treatment of other medical/social conditions during TB treatment.
AB - OBJECTIVES: This study aimed to analyze mortality, risk factors, and causes of death among people with tuberculosis (TB).METHODS: This is a population-based cohort study with patients with TB ≥18 years notified from 1990 to 2018 in Denmark, compared with sex- and age-matched controls. Mortality was assessed in Kaplan-Meier models and risk factors for death were estimated in Cox proportional hazards models.RESULTS: Overall mortality was twofold higher among people with TB compared with controls up to 15 years after TB diagnosis (hazard ratio [HR]: 2.18, 95% confidence interval [CI]: 2.06-2.29, P <0.0001). Danes with TB were three times more likely to die than migrants (adjusted HR: 3.13, 95% CI: 2.84-3.45, P <0.0001). Risk factors for death included living alone, being unemployed, having low income, and comorbidities such as mental illness with substance abuse, lung diseases, hepatitis, and HIV. TB was the most common cause of death (21%), followed by chronic obstructive pulmonary disease (7%), lung cancer (6%), alcoholic liver disease (5%), and mental illness with substance abuse (4%).CONCLUSION: People with TB had substantially inferior survival up to 15 years after TB diagnosis, in particular, socially disadvantaged Danes with TB with specific comorbidities. This may reflect unmet needs for enhanced treatment of other medical/social conditions during TB treatment.
KW - Comorbidity
KW - Death
KW - Public health
KW - Social risk factor
KW - TB
UR - http://www.scopus.com/inward/record.url?scp=85150451100&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2023.02.024
DO - 10.1016/j.ijid.2023.02.024
M3 - Journal article
C2 - 36907546
VL - 130
SP - 76
EP - 82
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
SN - 1201-9712
ER -