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 - Ekstrom, Claus Thorn

AU - Andersen, Peter Henrik

AU - Lillebaek, Troels

AU - Koch, Anders

PY - 2023

Y1 - 2023

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 < 0.0 0 01). Danes with TB were three times more likely to die than migrants (adjusted HR: 3.13, 95% CI: 2.84-3.45, P < 0.0 0 01). Risk factors for death included living alone, being unemployed, having low income, and co -morbidities 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 par-ticular, socially disadvantaged Danes with TB with specific comorbidities. This may reflect unmet needs for enhanced treatment of other medical/social conditions during TB treatment.(c) 2023 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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 < 0.0 0 01). Danes with TB were three times more likely to die than migrants (adjusted HR: 3.13, 95% CI: 2.84-3.45, P < 0.0 0 01). Risk factors for death included living alone, being unemployed, having low income, and co -morbidities 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 par-ticular, socially disadvantaged Danes with TB with specific comorbidities. This may reflect unmet needs for enhanced treatment of other medical/social conditions during TB treatment.(c) 2023 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

KW - TB

KW - Death

KW - Public health

KW - Social risk factor

KW - Comorbidity

KW - TRENDS

KW - NATIONWIDE

KW - REGISTER

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 -