中国城市中结核患者的死亡：回顾性队列研究

Department of Epidemiology, Key Laboratory of Public Health Safety, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China

BACKGROUND: The case-fatality rate for tuberculosis (TB) remains high in China, whereas risk factors for deaths among TB cases are still unclear. DESIGN: This was a retrospective cohort study of all pulmonary TB patients registered in four districts of Shanghai from 2004 to 2008. Data were derived from the China National TB Surveillance System. A total of 4271 patients were followed up in communities. Data were analysed using Cox regression. RESULTS: The percentage of all-cause deaths in the study population was 15% 2-6 years after the most recent TB diagnosis. TB was responsible for only 17% of all deaths; male sex was significantly associated with allcause deaths. After adjustment for sex, age and treatment history, four factors were significantly and independently associated with increased risk of death: psychopathy, chronic bronchitis, cancer and the presence of multiple diseases. TB was responsible for 7.2 potential years of life lost (PYLL); PYLL was higher in females (8.2) than males (5.3). CONCLUSIONS: TB remains a significant problem in urban China. Implementation of improved clinical management, prevention strategies and other public health programmes should target TB patients with chronic conditions, particularly those with multiple diseases. © 2013 The Union.

Xu, B.; Department of Epidemiology, Key Laboratory of Public Health Safety, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China; email:bxu@shmu.edu