Mortality and its influencing factors during anti-tuberculosis treatment in pulmonary tuberculosis patients in Hunan Province

Objectives Reducing mortality during anti-tuberculosis treatment is crucial for completing full-course standardized therapy and achieving tuberculosis cure. The study aims to analyze the mortality and its influencing factors among pulmonary tuberculosis patients undergoing anti-tuberculosis treatment in Hunan Province. Methods In this retrospective cohort study, data on pulmonary tuberculosis patients from the Hunan Provincial Tuberculosis Management Information System were collected between January 1, 2019 and December 31, 2023. The cumulative survival rate was estimated using life table methods. Survival rates were compared between groups using the Log-rank test. Cox proportional hazards regression analysis was then employed to explore the influencing factors on mortality during treatment. Results The tuberculosis case fatality rate during anti-tuberculosis treatment in Hunan Province was 0.24%, with the median survival time of tuberculosis-related deaths being 2.41 (2.18-2.63) months. Among the tuberculosis deaths, 47.28% (235/497) occurred during the intensive phase within the first 2 months of treatment. Cox regression analysis showed that older age, male gender, being a farmer, human immunodeficiency virus (HIV) positivity, retreatment status, positive bacteriological test results, medication management by healthcare personnel, and coexisting urinary tract tuberculosis were risk factors for mortality during treatment. Conclusions The tuberculosis case fatality rate during anti-tuberculosis treatment among pulmonary tuberculosis patients in Hunan Province is 0.24%. Patients with pulmonary tuberculosis who are older, male, farmers, HIV-positive, undergoing retreatment, have positive bacteriological test results, receive medication management by healthcare workers, or have coexisting urinary tract tuberculosis are at higher risk of death during treatment.