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. 2019 Aug 22;19(1):735.
doi: 10.1186/s12879-019-4365-9.

Clinical Profiles of Early and Tuberculosis-Related Mortality in South Korea Between 2015 and 2017: A Cross-Sectional Study

Free PMC article

Clinical Profiles of Early and Tuberculosis-Related Mortality in South Korea Between 2015 and 2017: A Cross-Sectional Study

Jinsoo Min et al. BMC Infect Dis. .
Free PMC article


Background: Although the incidence of tuberculosis (TB) has decreased in South Korea, the mortality rate remains high. TB mortality is a key indicator for TB control interventions. The purpose of this study was to assess early and TB-related mortality during anti-TB treatment and describe the associated clinical characteristics.

Methods: A multicenter cross-sectional study was performed across South Korea. Patients with pulmonary TB who died during anti-TB treatment and whose records were submitted to the national TB surveillance system between 2015 and 2017 were enrolled. All TB deaths were categorized based on cause (TB-related or non-TB-related) and timing (early or late). We identified statistical associations using the frequency table, chi-square test, and binary logistic regression.

Results: Of 5595 notifiable mortality cases, 3735 patients with pulmonary TB were included in the analysis. There were 2541 (68.0%) male patients, and 2935 (78.6%) mortality cases were observed in patients older than 65 years. There were 944 (25.3%) cases of TB-related death and 2545 (68.1%) cases of early death. Of all cases, 187 (5.0%) patients were diagnosed post-mortem and 38 (1.0%) patients died on the first day of treatment. Low body mass index (adjusted odds ratio (aOR) = 1.26; 95% confidence interval (CI) = 1.08-1.48), no reported illness (aOR = 1.36; 95% CI = 1.10-1.68), bilateral disease on chest X-ray (aOR = 1.30; 95% CI = 1.11-1.52), and positive acid-fast bacilli smear result (aOR = 1.30; 95% CI = 1.11-1.52) were significantly associated with early death, as well as TB-related death. Acute respiratory failure was the most common mode of non-TB-related death. Malignancy was associated with both late (aOR = 0.71; 95% CI = 0.59-0.89) and non-TB-related (aOR = 0.35; 95% CI = 0.26-0.46) death.

Conclusions: A high proportion of TB death was observed in elderly patients and attributed to non-TB-related causes. Many TB-related deaths occurred during the intensive phase, particularly within the first month. Further studies identifying risk factors for different causes of TB death at different phases of anti-TB treatment are warranted for early targeted intervention in order to reduce TB mortality.

Keywords: Death; Elderly; Korea; PPM; Private-public mix.

Conflict of interest statement

All authors declare that they have no competing interests.


Fig. 1
Fig. 1
Flow chart of enrollment of tuberculosis mortality cases between 2015 and 2017, which were finally categorized based on cause (tuberculosis-related and non-tuberculosis related) and timing (early and late) TB, tuberculosis
Fig. 2
Fig. 2
Number of tuberculosis-related, non-tuberculosis-related, and all death cases stratified by intervals between diagnosis and death. TB, tuberculosis
Fig. 3
Fig. 3
Log-Log plot describing variables, which were significantly associated with subsets of TB death (TB-related, non-TB-related, early and late deaths). TB, tuberculosis; AFB, acid-fast bacillus; BMI, body mass index; Hx, history

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