Poor performance status is associated with early death in patients with pulmonary tuberculosis

Trans R Soc Trop Med Hyg. 2006 Jul;100(7):681-6. doi: 10.1016/j.trstmh.2005.09.007. Epub 2005 Nov 28.


The objective of this study was to determine whether poor performance status at the start of anti-tuberculous (anti-TB) treatment is associated with early death in patients admitted to hospital with pulmonary tuberculosis (PTB). During 3 months in 2001, all adult patients admitted to eight hospitals in Limpopo Province, South Africa, and diagnosed with PTB were eligible for inclusion. At initiation of anti-TB treatment, a performance status between 0 and 4 was estimated for each patient using a modified version of the Eastern Cooperative Oncology Group scoring system. Hospital records and local TB registers were reviewed to identify patients who had died during the first 2 months of treatment. In addition, it was ascertained whether a death notification had been received by the provincial administration. Fifty-three of 295 (18%) patients died within 2 months. Mortality increased from 6% in patients with the best performance status to 51% in patients with the poorest performance status. Univariate and multivariate Cox regression analysis showed that the hazard ratio for dying was significantly higher for patients with a performance status of 3 or 4. Poor performance status shows a strong association with early death in patients with PTB and has the potential to be a useful clinical, epidemiological and research tool.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Disability Evaluation*
  • Epidemiologic Methods
  • Exercise
  • Female
  • Humans
  • Male
  • Middle Aged
  • Self Care
  • Sex Distribution
  • South Africa / epidemiology
  • Time Factors
  • Tuberculosis, Pulmonary / mortality*