PMID- 34271181
OWN - NLM
STAT- MEDLINE
DCOM- 20220315
LR  - 20220531
IS  - 1469-0691 (Electronic)
IS  - 1198-743X (Linking)
VI  - 28
IP  - 3
DP  - 2022 Mar
TI  - Current in-hospital management for patients with tuberculosis in a high-income 
      country: a retrospective cohort study.
PG  - 383-390
LID - S1198-743X(21)00385-2 [pii]
LID - 10.1016/j.cmi.2021.07.011 [doi]
AB  - OBJECTIVES: In Japan, most cases of tuberculosis (TB) occur among individuals 
      aged 65 years or older. However, data on in-hospital adverse events (AEs) 
      associated with TB management, especially in high-income nations with an ageing 
      population, are scarce. The present study aimed to scrutinize the current TB unit 
      practices, incidence of in-hospital AEs and predictors of in-hospital mortality. 
      METHODS: This retrospective cohort study was conducted at a tertiary care centre 
      in Tokyo, Japan from 2012 to 2017. Inpatients with the diagnosis of TB and aged 
      >18 years were included. Quality of in-hospital care and factors associated with 
      in-hospital mortality were investigated using multivariate logistic regression 
      analysis. RESULTS: In total, 448 patients were enrolled. The in-hospital 
      mortality rate was 16.7% (75/448). Miliary/disseminated TB was common (59/448, 
      13.2%), especially in those who died (17/75, 22.7%). Factors independently 
      associated with in-hospital mortality were a low Karnofsky performance status 
      score on admission (score: 40-10, adjusted odds ratio (aOR) 25.65, 95% CI 
      5.63-116.92 and score: 70-50, aOR 9.47, 95% CI 2.07-43.3), age over 89 years (aOR 
      3.68, 95% CI 1.08-12.46), Charlson Co-morbidity Index >5 (aOR 3.56, 95% CI 
      1.37-9.21), development of any health-care-associated infection (aOR 2.95, 95% CI 
      1.35-6.41), and development of any drug-related AE leading to discontinuation of 
      anti-TB agents (seven patients were unable to resume treatment with anti-TB 
      agents before death) (aOR 2.29, 95% CI 1.02-5.11). CONCLUSIONS: In-hospital AEs 
      (i.e. health-care-associated infection and drug-related AEs), as well as 
      patient-related variables, were associated with in-hospital mortality among TB 
      patients.
CI  - Copyright (c) 2021 European Society of Clinical Microbiology and Infectious 
      Diseases. Published by Elsevier Ltd. All rights reserved.
FAU - Takamatsu, Akane
AU  - Takamatsu A
AD  - Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Centre, Tokyo, 
      Japan; Department of Microbiology, Juntendo University Graduate School of 
      Medicine, Tokyo, Japan.
FAU - Kano, Yasuhiro
AU  - Kano Y
AD  - Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Centre, Tokyo, 
      Japan.
FAU - Tagashira, Yasuaki
AU  - Tagashira Y
AD  - Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Centre, Tokyo, 
      Japan.
FAU - Kirikae, Teruo
AU  - Kirikae T
AD  - Department of Microbiology, Juntendo University Graduate School of Medicine, 
      Tokyo, Japan.
FAU - Honda, Hitoshi
AU  - Honda H
AD  - Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Centre, Tokyo, 
      Japan. Electronic address: hhhhonda@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20210713
PL  - England
TA  - Clin Microbiol Infect
JT  - Clinical microbiology and infection : the official publication of the European 
      Society of Clinical Microbiology and Infectious Diseases
JID - 9516420
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - Adolescent
MH  - Aged
MH  - Aged, 80 and over
MH  - Antitubercular Agents/therapeutic use
MH  - Hospitals
MH  - Humans
MH  - Japan/epidemiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Tuberculosis/diagnosis/drug therapy/epidemiology
OTO - NOTNLM
OT  - Adverse events
OT  - Hospital care
OT  - In-hospital care
OT  - In-hospital mortality
OT  - Mycobacterium tuberculosis
EDAT- 2021/07/17 06:00
MHDA- 2022/03/16 06:00
CRDT- 2021/07/16 20:19
PHST- 2021/02/13 00:00 [received]
PHST- 2021/07/05 00:00 [revised]
PHST- 2021/07/05 00:00 [accepted]
PHST- 2021/07/17 06:00 [pubmed]
PHST- 2022/03/16 06:00 [medline]
PHST- 2021/07/16 20:19 [entrez]
AID - S1198-743X(21)00385-2 [pii]
AID - 10.1016/j.cmi.2021.07.011 [doi]
PST - ppublish
SO  - Clin Microbiol Infect. 2022 Mar;28(3):383-390. doi: 10.1016/j.cmi.2021.07.011. 
      Epub 2021 Jul 13.