Characteristics of tuberculosis-related deaths and risk factors: a retrospective cohort study in Samsun province of Turkey

OBJECTIVES: Tuberculosis (TB) remains one of the top ten leading causes of death worldwide despite effective therapy. The present study aims to examine the characteristics of TB-related deaths in Samsun Province and to determine the risk factors. METHODS: In this retrospective registry-based cohort study, the medical records of patients registered with Samsun Tuberculosis Control Dispensary between 1 January 2018 and 31 December 2019 were retrospectively reviewed. The Cox proportional-hazards model was used to determine the factors associated with the risk of death in patients with TB. RESULTS: The treatment outcomes of a total of 382 patients were reviewed. It was found that the treatment was successful in 346 patients (90.6%), and 31 patients (8.1%) died before or during TB therapy. The median survival time of patients who died during the therapy was 1.86 months (95% CI = 0.07-5.17 months), and more than 50% (13/25) of the deaths occurred in the first two months of the treatment. Age above 70 years (HR 15.06 (3.33-67.95)), male gender (HR 2.74 (1.02-7.33)), pulmonary TB (HR 2.92 (1.002-8.52)), multidrug-resistant (MDR) tuberculosis (HR 1.69 (1.22-12.75)), and a delay in the treatment of more than ten days (HR 2.71 (1.22-6.04)) were identified as risk factors associated with mortality in TB patients (p < 0.05). CONCLUSION: The majority of deaths in our cohort occurred within the first two months after starting the treatment. Advanced age, male sex, a new diagnosis of TB, pulmonary TB, MDR-TB, and a treatment delay of more than ten days after diagnosis increased the risk for mortality during antituberculosis treatment.