In summary, we have identified a series of characteristics that are predictive of mortality for hospitalized patients with tuberculosis. Our data suggest that among patient populations with low levels of coinfection with HIV and MDRTB, markers of general debilitation and disease chronicity such as respiratory failure, age, dialysis dependence, and malnutrition play important roles in determining patient outcome. The recent resurgence of tuberculosis in the United States has come to be symbolized by the experiences in large urban centers such as New York City, San Francisco, CA, and Miami, FL, where the epidemiology of tuberculosis has been affected by large immigrant and HIV-seropositive populations. This characterization is not without merit since 92% of the increase in tuberculosis cases in the United States was from just five states. However, one must be careful when applying the experience in these areas to other parts of the country. Our study may have greater applicability to regions of the United States, where, like St. Louis, the characteristics of tuberculosis have been less affected by the AIDS epidemic. With this caveat in mind, the data presented herein should improve our assessment of the prognosis of patients hospitalized with tuberculosis. The identification of potentially reversible factors such as malnutrition and respiratory failure suggests specific interventions that may lead to improvements in patient outcomes. Finally, we identified patients who are at the greatest risk for mortality from tuberculosis disease due to the chronicity and severity of their underlying disease. Canadian neightbor pharmacy More info Additionally, our data showed no survival advantage for such patients who received antituberculous therapy compared with those who went untreated or who had experienced significant treatment delays. Therefore, measures aimed at the prevention of tuberculosis (eg, chemoprophylaxis) may be the most effective means available for reducing the mortality attributed to tuberculosis in patients at high risk for death.
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