Table 4.
Risk factors for mortality during anti-tuberculosis treatment in patients with extrapulmonary tuberculosis in Texas, USA, 2009–2015
| Variable | Treatment completed (n = 1061) | Died during treatment (n = 50) | Mortality risk (%) | Crude OR (95% CI) | Adjusted OR (95% CI) | Adjusted p-Value |
|---|---|---|---|---|---|---|
| Age (years) | ||||||
| 0–14 | 105 (9.9%) | 0 (0.0%) | 0.0% | – | ||
| 15–24 | 116 (10.9%) | 2 (4.0%) | 1.7% | (reference) | ||
| 25–44 | 438 (41.3%) | 9 (18.0%) | 2.0% | 1.19 (0.25, 5.59) | ||
| 45–64 | 292 (27.5%) | 17 (34.0%) | 5.5% | 3.38 (0.77, 14.85) | ||
| ≥65 | 110 (10.4%) | 22 (44.0%) | 16.7% | 11.60 (2.66, 50.49) | ||
| Age (years) | ||||||
| <45 | 659 (62.1%) | 11 (22.0%) | 1.6% | (reference) | (reference) | |
| ≥45 | 402 (37.9%) | 39 (78.0%) | 8.8% | 5.81 (2.94, 11.48) | 3.75 (1.71, 8.22) | 0.001 |
| Gender | ||||||
| Female | 491 (46.3%) | 20 (40.0%) | 3.9% | (reference) | ||
| Male | 570 (53.7%) | 30 (60.0%) | 5.0% | 1.29 (0.72, 2.30) | ||
| Race | ||||||
| White | 84 (7.9%) | 9 (18.0%) | 9.7% | (reference) | ||
| Black | 209 (19.7%) | 11 (22.0%) | 5.0% | 0.49 (0.20, 1.23) | ||
| Hispanic | 501 (47.2%) | 24 (48.0%) | 4.6% | 0.45 (0.20, 1.00) | ||
| Asian | 262 (24.7%) | 6 (12.0%) | 2.2% | 0.21 (0.07, 0.62) | ||
| Other | 5 (0.5%) | 0 (0.0%) | 0.0% | 1.00 (0.00, 0.00) | ||
| Race | ||||||
| Non-White | 977 (92.1%) | 41 (82.0%) | 4.0% | (reference) | ||
| White | 84 (7.9%) | 9 (18.0%) | 9.7% | 2.55 (1.20, 5.43) | ||
| HIV status | ||||||
| Negative | 847 (79.8%) | 21 (42.0%) | 2.4% | (reference) | (reference) | |
| Positive | 53 (5.0%) | 6 (12.0%) | 10.2% | 4.57 (1.77, 11.79) | 4.70 (1.54, 14.32) | 0.01 |
| Unknown | 161 (15.2%) | 23 (46.0%) | 12.5% | 5.76 (3.11, 10.66) | 6.55 (3.19, 13.44) | <0.001 |
| Homeless | ||||||
| No | 1040 (98.0%) | 46 (92.0%) | 4.2% | (reference) | (reference) | |
| Yes | 21 (2.0%) | 4 (8.0%) | 16.0% | 4.31 (1.42, 13.06) | 1.57 (0.40, 6.17) | 0.52 |
| Excessive alcohol use | ||||||
| No | 973 (91.7%) | 37 (74.0%) | 3.7% | (reference) | (reference) | |
| Yes | 88 (8.3%) | 13 (26.0%) | 12.9% | 3.88 (1.99, 7.58) | 3.34 (1.45, 7.67) | 0.01 |
| Injecting drug use | ||||||
| No | 1050 (99.0%) | 48 (96.0%) | 4.4% | (reference) | ||
| Yes | 11 (1.0%) | 2 (4.0%) | 15.4% | 3.98 (0.86, 18.44) | ||
| Foreign born | ||||||
| No | 415 (39.1%) | 29 (58.0%) | 6.5% | (reference) | ||
| Yes | 646 (60.9%) | 21 (42.0%) | 3.1% | 0.47 (0.26, 0.83) | ||
| Diabetes | ||||||
| No | 948 (89.3%) | 40 (80.0%) | 4.0% | (reference) | (reference) | |
| Yes | 113 (10.7%) | 10 (20.0%) | 8.1% | 2.10 (1.02, 4.31) | 1.55 (0.65, 3.69) | 0.32 |
| End-stage renal disease | ||||||
| No | 1043 (98.3%) | 44 (88.0%) | 4.0% | (reference) | (reference) | |
| Yes | 18 (1.7%) | 6 (12.0%) | 25.0% | 7.90 (2.99, 20.88) | 4.45 (1.38, 14.33) | 0.01 |
| Immunosuppression (medical condition or medication) | ||||||
| No | 1027 (96.8%) | 44 (88.0%) | 4.1% | |||
| Yes | 34 (3.2%) | 6 (12.0%) | 15.0% | 4.12 (1.64, 10.32) | ||
| Previous TB | ||||||
| No | 1033 (97.4%) | 50 (100.0%) | 4.6% | – | ||
| Yes | 28 (2.6%) | 0 (0.0%) | 0.0% | |||
| Inmate of a correctional facility | ||||||
| No | 967 (94.8%) | 48 (98.0%) | 4.7% | (reference) | ||
| Yes | 53 (5.2%) | 1 (2.0%) | 1.9% | 0.38 (0.05, 2.81) | ||
| Resident of long-term care facility | ||||||
| No | 1048 (98.8%) | 47 (94.0%) | 4.3% | (reference) | (reference) | |
| Yes | 13 (1.2%) | 3 (6.0%) | 18.8% | 5.15 (1.42, 18.67) | 2.15 (0.50, 9.26) | 0.31 |
| AFB smear | ||||||
| Negative | 627 (99.4%) | 17 (94.4%) | 2.6% | (reference) | ||
| Positive | 4 (0.6%) | 1 (5.6%) | 20.0% | 9.22 (0.98, 86.93) | ||
| Culture | ||||||
| Negative | 602 (97.6%) | 12 (92.3%) | 2.0% | (reference) | ||
| Positive | 15 (2.4%) | 1 (7.7%) | 6.3% | 3.34 (0.41, 27.40) | ||
| TB-CXR | ||||||
| No | 611 (62.8%) | 15 (33.3%) | 2.4% | (reference) | (reference) | |
| Yes | 362 (37.2%) | 30 (66.7%) | 7.7% | 3.38 (1.79, 6.36) | 2.18 (1.09, 4.35) | 0.03 |
| Cavitation on CXR | ||||||
| No | 354 (97.8%) | 30 (100.0%) | 7.8% | – | ||
| Yes | 8 (2.2%) | 0 (0.0%) | 0.0% | |||
| DST profile | ||||||
| Sensitive to RIF and INH | 560 (52.8%) | 40 (80.0%) | 6.7% | |||
| Resistant to RIF or INH | 39 (3.7%) | 0 (0.0%) | 0.0% | |||
| MDR-TB | 3 (0.3%) | 0 (0.0%) | 0.0% | (reference) | ||
| Unavailable | 459 (43.3%) | 10 (20.0%) | 2.1% | 0.31 (0.15, 0.62) | ||
| Genotyping lineage | ||||||
| Indo-Oceanic (L1) | 80 (7.5%) | 4 (8.0%) | 4.8% | 0.79 (0.20, 3.05) | ||
| East Asian (L2) | 79 (7.4%) | 5 (10.0%) | 6.0% | (reference) | ||
| East African-Indian (L3) | 35 (3.3%) | 1 (2.0%) | 2.8% | 0.45 (0.05, 4.01) | ||
| Euro-American (L4) | 300 (28.3%) | 27 (54.0%) | 8.3% | 1.42 (0.53, 3.81) | ||
| M. bovis | 27 (2.5%) | 3 (6.0%) | 10.0% | 1.76 (0.39, 7.84) | ||
| Other | 8 (0.8%) | 0 (0.0%) | 0.0% | 1.00 (0.00, 0.00) | ||
| Unknown | 532 (50.1%) | 10 (20.0%) | 1.8% | 0.30 (0.10, 0.89) | ||
| Genotyping lineage | ||||||
| Not East Asian | 354 (97.8%) | 30 (100.0%) | 7.8% | (reference) | (reference) | |
| East Asian (L2) | 8 (2.2%) | 0 (0.0%) | 0.0% | 1.38 (0.53, 3.58) | 1.58 (0.53, 4.74) | 0.42 |
TB tuberculosis, HIV human immunodeficiency virus, TB-CXR tuberculosis chest X-ray, DST drug susceptibility test, RIF rifampin, INH isoniazid, MDR-TB multidrug-resistant tuberculosis, OR odds ratios
Analysis was performed on 1111 patients with extrapulmonary tuberculosis only and having treatment outcome information available