In:
Respiration, S. Karger AG, Vol. 86, No. 6 ( 2013), p. 472-478
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Few studies have investigated the impact of diabetes mellitus (DM), a globally increasing metabolic disease, on treatment outcomes and long-term survival in patients with multidrug-resistant forms of tuberculosis (MDR-TB). 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 We analyzed outcomes in a large cohort to assess the impact of DM on treatment outcomes of patients with MDR-TB. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 MDR-TB patients newly diagnosed or retreated between 2000 and 2002 and followed for 8-11 years were retrospectively analyzed with respect to the effect of DM as a comorbidity on their treatment outcome and long-term survival. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of 1,407 patients with MDR-TB, 239 (17.0%) had coexisting DM. The mean age and body mass index were higher in MDR-TB patients with DM [MDR-TB 〈 sub 〉 DM(+) 〈 /sub 〉 ] than in those without DM [MDR-TB 〈 sub 〉 DM(-) 〈 /sub 〉 ]. Patients with MDR-TB and a comorbidity of DM had a significantly lower treatment success rate than those without a history of DM (36.0 vs. 47.2%, p = 0.002). In addition, DM was the negative predictor for MDR-TB treatment success in multivariate analyses [odds ratio 0.51, 95% confidence interval (CI) 0.26-0.99] . Mean survival times were also lower in MDR-TB 〈 sub 〉 DM(+) 〈 /sub 〉 than in MDR-TB 〈 sub 〉 DM(-) 〈 /sub 〉 patients (102 vs. 114 months, p = 0.001), with DM as a significant predictor of poor long-term survival in multivariate analyses (hazard ratio 1.59, 95% CI 1.01-2.50). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Among MDR-TB patients, DM was a relatively common comorbidity. In patients undergoing treatment for MDR-TB and followed for 8-11 years, it was found to be independently associated with an increased risk of both treatment failure and death.
Type of Medium:
Online Resource
ISSN:
0025-7931
,
1423-0356
Language:
English
Publisher:
S. Karger AG
Publication Date:
2013
detail.hit.zdb_id:
1464419-8
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