Table 3.
Odds ratiosa for TB-specific mortality and non–TB-specific mortality, by sociodemographic and clinical risk factors, among patients with TB in the United States reported to the National Tuberculosis Surveillance System, 2009-2013b
| Risk Factors | TB-Specific Mortality | Non–TB-Specific Mortality | ||
|---|---|---|---|---|
| OR (95% CI) | aOR (95% CI) | OR (95% CI) | aOR (95% CI) | |
| Age group, y | ||||
| 0-14 | 0.41 (0.23-0.74) | 0.08 (0.01-0.61) | 0.18 (0.08-0.39) | 0.21 (0.05-0.86) |
| 15-24 | 0.37 (0.24-0.58) | 0.36 (0.19-0.70) | 0.24 (0.14-0.40) | 0.30 (0.15-0.62) |
| 25-44 | 1 [Reference] | |||
| 45-64 | 2.93 (2.45-3.50) | 2.57 (2.01-3.30) | 4.11 (3.51-4.81) | 3.69 (2.90-4.69) |
| ≥65 | 8.31 (7.03-9.83) | 5.76 (4.37-7.61) | 13.71 (11.81-15.92) | 8.55 (6.61-11.07) |
| Male sex | 1.31 (1.17-1.47) | 1.36 (1.16-1.59) | 1.29 (1.18-1.40) | 1.41 (1.24-1.61) |
| Country of birth and race/ethnicity | ||||
| Foreign born | ||||
| Non-Hispanic Asian | 0.44 (0.37-0.52) | 0.67 (0.53-0.84) | 0.42 (0.37-0.52) | 0.78 (0.66-0.94) |
| Non-Hispanic African American | 0.28 (0.21-0.37) | 0.70 (0.46-1.06) | 0.20 (0.15-0.25) | 0.83 (0.60-1.15) |
| Hispanic | 0.48 (0.40-0.56) | 1.08 (0.85-1.37) | 0.35 (0.30-0.40) | 0.87 (0.71-1.06) |
| Non-Hispanic white | 0.58 (0.42-0.80) | 0.80 (0.52-1.23) | 0.55 (0.44-0.70) | 0.93 (0.67-1.29) |
| Non-Hispanic otherc or unknown | 0.43 (0.27-0.70) | 0.80 (0.40-1.63) | 0.26 (0.17-0.40) | 0.80 (0.45-1.43) |
| US born | ||||
| Non-Hispanic Asian | 0.25 (0.12-0.51) | 0.85 (0.29-2.46) | 0.34 (0.22-0.52) | 0.99 (0.43-2.30) |
| Non-Hispanic African American | 1.11 (0.88-1.40) | 1.13 (0.90-1.43) | 0.80 (0.71-0.91) | 1.05 (0.87-1.26) |
| Hispanic | 0.62 (0.50-0.78) | 1.39 (0.99-1.94) | 0.39 (0.32-0.47) | 1.05 (0.77-1.43) |
| Non-Hispanic white | 1 [Reference] | |||
| Non-Hispanic otherc or unknown | 1.32 (0.97-1.80) | 1.97 (1.29-3.00) | 0.73 (0.55-0.98) | 1.26 (0.83-1.89) |
| Long-term care facility resident at time of TB diagnosisd | 5.73 (4.66-7.05) | 2.08 (1.55-2.79) | 7.84 (6.76-9.10) | 2.70 (2.15-3.39) |
| Primary occupation | ||||
| High-risk occupatione | 0.59 (0.35-1.00) | 1.00 (0.51-1.93) | 0.67 (0.43-1.03) | 1.06 (0.60-1.86) |
| Not employed | 2.10 (1.81-2.45) | 1.88 (1.52-2.34) | 2.83 (2.49-3.22) | 2.19 (1.81-2.66) |
| Retired | 6.87 (5.87-8.05) | 1.98 (1.52-2.57) | 9.84 (8.61-11.23) | 2.47 (1.97-3.08) |
| Other or unknown | 1 [Reference] | |||
| Site of TB disease | ||||
| Pulmonary only | 1 [Reference] | |||
| Extrapulmonary only | 0.52 (0.44-0.61) | 0.53 (0.40-0.69) | 0.86 (0.77-0.95) | 0.91 (0.76-1.09) |
| Both | 1.84 (1.60-2.13) | 1.96 (1.61-2.39) | 1.16 (1.01-1.32) | 1.32 (1.09-1.59) |
| Type of TB therapy | ||||
| Self-administered | 0.79 (0.64-0.98) | 0.94 (0.72-1.22) | 0.85 (0.72-1.01) | 0.84 (0.67-1.05) |
| Directly observed | 1 [Reference] | |||
| Both | 0.20 (0.16-0.25) | 0.20 (0.16-0.26) | 0.42 (0.36-0.48) | 0.47 (0.40-0.55) |
| Unknown | 1.17 (0.60-2.28) | 0.73 (0.28-1.89) | 1.13 (0.65-1.98) | 0.74 (0.33-1.68) |
| HIV status at time of TB diagnosis | ||||
| Positive | 2.41 (1.98-2.93) | 2.63 (2.02-3.42) | 2.66 (2.30-3.08) | 2.67 (2.13-3.36) |
| Negative | 1 [Reference] | |||
| Testing not offered | 7.78 (6.86-8.84) | 4.77 (3.96-5.76) | 7.38 (6.66-8.17) | 3.41 (2.89-4.02) |
| Otherf or unknown | 2.47 (2.03-3.01) | 1.58 (1.19-2.11) | 2.85 (2.47-3.29) | 1.76 (1.42-2.17) |
| Additional TB risk factorsg | ||||
| Diabetes mellitus | 1.92 (1.69-2.19) | 1.10 (0.89-1.36) | 2.01 (1.82-2.22) | 0.96 (0.81-1.14) |
| End-stage renal disease | 6.11 (4.97-7.50) | 3.02 (2.23-4.08) | 7.77 (6.67-9.05) | 2.97 (2.33-3.78) |
| Any immunosuppressionh | 3.05 (2.56-3.63) | 2.20 (1.71-2.83) | 4.55 (4.03-5.13) | 2.76 (2.28-3.33) |
| Other | 1.60 (1.42-1.81) | 1.38 (1.12-1.59) | 1.77 (1.62-1.94) | 1.35 (1.14-1.59) |
| None reported | 0.65 (0.58-0.72) | 0.95 (0.76-1.18) | 0.48 (0.44-0.53) | 0.74 (0.62-0.89) |
| Reason evaluated | ||||
| Abnormal chest x-ray | 1.27 (1.07-1.52) | 1.68 (1.29-2.18) | 1.01 (0.90-1.14) | 1.34 (1.10-1.62) |
| Contact with a TB patient | 0.18 (0.10-0.33) | 0.40 (0.16-1.01) | 0.11 (0.07-0.18) | 0.30 (0.14-0.65) |
| TB symptoms | 1.16 (1.00-1.35) | 1.65 (1.30-2.08) | 0.65 (0.59-0.73) | 1.13 (0.95-1.34) |
| Otheri or unknown | 1 [Reference] | |||
| MDR TB diagnosisj | 1.11 (0.70-1.77) | 3.42 (1.95-5.99) | 0.48 (0.28-0.82) | 1.05 (0.48-2.28) |
Abbreviations: aOR, adjusted odds ratio; HIV, human immunodeficiency virus; MDR, multidrug resistant; OR, odds ratio; TB, tuberculosis.
aORs are based on multinomial logistic regression analysis. All variables included in the multinomial regression model were selected through all of the following model selection methods: backward elimination, stepwise selection, and forward selection. Diabetes mellitus was forced into the multinomial logistic regression model because of its clinical significance.
bData source: National Tuberculosis Surveillance System, 2009-2013, Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention.
cIncludes multiracial, Native Hawaiian/other Pacific Islander, and American Indian/Alaska Native.
dReference category: not residing in a long-term care facility at the time of TB diagnosis.
eIncludes correctional employees and health care workers.
fIncludes HIV test refused, result indeterminate, and test done but results unknown.
gReference category: the absence of any report per risk factor.
hIncludes immunosuppression, post–organ transplantation, and/or on tumor necrosis factor alpha–antagonist therapy.
iIncludes health care worker, employment/administrative test, immigration medical examination, incident laboratory result, and targeted TB testing.
jReference category: absence of an MDR TB diagnosis.