Medicine of the Future in America

Hospitalizations for Tuberculosis

Hospitalizations for Tuberculosis Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis and transmitted by aerosolized droplet nuclei, infecting approximately one third of the world population. In 1997, it was estimated that almost 2 million people died of TB worldwide, with a case fatality rate as high as 23%. In the United States, active TB disease usually can be treated successfully, with an extended therapeutic course of a combination of antibiotics, often using directly observed therapy (DOT). According to a recent expert consensus statement,2 “it is well established that appropriate therapy of TB rapidly renders the patient noninfectious… minimizes the risk of disability or death from TB and nearly eliminates the possibility of relapse.” Despite the availability of curative therapy, TB affects the quality of life of the people infected. A large proportion of patients with TB are being hospitalized, and inhospital mortality remains high, with estimates of mortality rates ranging widely from 2 to 12%. Some studies have examined the costs of TB hospitalizations, however, few investigations have addressed the poor outcomes of hospitalized patients with TB.

Comorbidity, including high rates of HIV, and delayed treatment have been implicated as the causes for the high mortality rates of hospitalized patients with TB in international or regional studies in the United States. To our knowledge, previous studies have not examined a nationally representative sample of hospitalized patients with TB. The purpose of this investigation was to characterize the patients hospitalized with TB in the United States in year 2000 and to identify the predictors of in-hospital mortality.

Materials and Methods
Study Design and Population

Using an administrative database, we conducted a crosssectional study characterizing hospitalizations for TB in the United States in 2000. Patients selected for this study had a primary discharge diagnosis of TB, using the International Classification of Diseases, ninth revision (ICD-9), hospital discharge codes 010.xx to 018.xx.

This entry was posted in Tuberculosis and tagged Epidemiology, health-care costs, hospitalization, mycobacterium, outcomes, tuberculosis.
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