Eight year survey of tuberculosis in-hospital mortality in the South Eastern part of Romania

O. C. Arghir, E. Dantes, M. Otelea, A. Rascu, E. Borgazi, S. C. Cambrea

Abstract: Romania remains a high burden TB European country, with an incidence of 70.2%000 in 2014 although the incidence, mortality, and morbidity are constantly decreasing.
Objectives. To determine the level of TB-associated mortality in the deaths cohort of inpatients from Clinical Pneumophtisiology Hospital and identifying the risk factors of TB death-related.
Material and method. A retrospective study was done recording demographic characteristics, comorbidities, duration of the hospitalization since death, chest Xray pattern, HIV, and drug-resistant status, and TB category were recorded.
Results. From a total of 4,609 TB patients 247 deaths due to all causes were registered from 2010 to 2017, from witch 126 deaths were caused by tuberculosis disease (51%) with an overall fatality rate of 2.7%. Most cases with TB deaths (n=7.26.5%), were declared new cases of TB. Death occurred in the first 7 days (55.5%). The mean interval of surviving after admission in hospital was 13.09 days +/- 14.355 std dev; F=17.698; p=0.000). Comorbidities associated with TB were alcoholism (32%), COPD (14%), malignancies (3.6%), diabetes (7%), heart disease (5%), hepatitis and liver cirrhosis (4%), AIDS (0.8%). Risk factors consisted in delayed diagnosis of extensive fibro-cavitary pulmonary tuberculosis active disease (74.6%), male gender, age under 60 year-old, low income or homelessness (15%), unemployment and the absence of medical insurance (35%), cachexia (58%), MDR (n=1; 0.8%) were identified. 12 patients died due to massive hemoptysis. Delayed anti TB therapy was noticed in 21% with negative smears.
Conclusion. Tuberculosis remains an important cause of mortality in a Tertiary Care Pneumophtisiology hospital.
Keywords: tuberculosis, in-hospital mortality, comorbidities.