To analyse mortality, risk factors and causes of death among people with tuberculosis (TB).
Population-based cohort study with TB patients ≥18 years notified 1990-2018 in Denmark, compared with sex- and age-matched controls. Mortality was assessed in Kaplan Meier models and risk factors for death estimated in Cox proportional hazards models.
Overall mortality was twofold higher among people with TB compared with controls up to 15 years after TB diagnosis (Hazard ratio (HR): 2.18, 95% confidence interval (CI): (2.06 – 2.29), p<.0001). Danes with TB were three times more likely to die than migrants (adjusted HR: 3.13, 95% (2.84 – 3.45), p<.0001). Risk factors for death included living alone, being unemployed, having low income, and comorbidities such as mental illness with substance abuse (MISA), lung diseases, hepatitis, and HIV. TB was the most common cause of death (21%), followed by COPD (7%), lung cancer (6%), alcoholic liver disease (5%), and MISA (4%).
People with TB had substantially inferior survival up to 15 years after TB diagnosis, in particular socially disadvantaged Danes with TB with specific comorbidities. This may reflect unmet needs for enhanced treatment of other medical/social conditions during TB treatment.
Copyright © 2023. Published by Elsevier Ltd.