No statistically significant pairwise interactions were demonstrated among the variables identified to be independently associated with mortality by logistic regression analysis. Elimination of respiratory failure from the logistic regression model did not uncover any additional hidden variables predictive of 14-month mortality. The Kaplan-Meier survival curves for respiratory failure and end-stage renal disease are shown in Figures 1 and 2. Cox proportional-hazards modeling identified two factors, respiratory failure requiring mechanical ventilation (risk ratio = 1.83; 95% Cl = 1.48 to 2.27; p = 0.005) and end-stage renal disease requiring dialysis (risk ratio = 1.89; 95% Cl — 1.43 to 2.50; p = 0.024), that independently predicted the duration of survival from hospital admission. We tested the validity of the proportional-hazards assumption and found no evidence of an increasing or decreasing trend over time in the hazard ratio.
Of the 203 patients hospitalized within the BJC Health System who were diagnosed as having tuberculosis, 57 died within 14 months of admission, corresponding to an all-cause mortality rate of 28.1%. Using multivariate analysis, we identified respiratory failure requiring mechanical ventilation and end-stage renal disease requiring dialysis as the most important factors independently associated with patient mortality Reading here my canadian pharmacy phone number. Additionally, we demonstrated that this cohort had the traditional demographic features and risk factors for tuberculosis commonly observed prior to the onset of the HIV epidemic and the emergence of MDRTB. Concomitant infection with HIV and the presence of MDRTB were relatively uncommon in our patient population, distinguishing it from other mortality studies of tuberculosis that have involved younger and primarily outpatient populations. We are aware of no prior studies that have examined the determinants of mortality in hospitalized patients with tuberculosis in an intermediate-sized urban and suburban location in the United States with moderate incidences of HIV and MDRTB. Therefore, these data may be of value to other health-care providers caring for patients with tuberculosis in geographic areas with patient characteristics similar to those observed in our study population.
Figure 1. Kaplan-Meier survival curves for patients with respiratory’ failure requiring mechanical ventilation ( + MV, closed circles) and patients without respiratory failure ( — MV, closed triangles).
Figure 2. Kaplan-Meier survival curves for patients with chronic renal failure requiring hemodialysis ( + CRF, closed circles) and patients without chronic renal failure ( — CRF, closed triangles).