老年結核病死亡相關因子探討

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 公共衛生學院 > 環境醫學研究所(已停用) > 博碩士論文 > Item 310903500/32422

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题名:	老年結核病死亡相關因子探討 A Study on the Risk Factors of Tuberculosis Deaths in The Elderly
作者:	劉慧君;Liu Hui Chun
贡献者:	公共衛生學院環境醫學研究所碩士班
关键词:	結核病;共存疾病;死亡;重症照護;tuberculosis;comorbidity;death;intensive care
日期:	2010
上传时间:	2010-09-29 12:03:32 (UTC+8)
摘要:	目的：本研究為了比較死亡個案和完治個案，以探討老年結核病治療結果相關因子方法：本研究以病例對照研究法（case-control study）進行研究，利用行政院衛生署疾病管制局「中央傳染病追蹤系統」2006年期間通報結核病為研究對象，死亡個案為病例組，完成治療個案為對照組。以通報個案的人口學特徵及共病疾病史等相關因子與治療結果間進行描述性統計及羅吉斯回歸分析。結果：已設籍彰化對359位接受結核病的治療個案納入本研究，其中死亡的個案有173位，完治個案有186位。兩組間性別、年齡及抽菸史有相似的分布情形，死亡的個案有較高慢性腎疾病、癌症和其他的共病史。從多變項羅吉斯迴歸分析結果發現，顯著的相關因素如下：結核病病患之腎絲球過濾率第Ⅴ分期（勝算比(odds ratio (OR) =6.32, 95%可信限 confidence interval (CI)）: 1.13-35.28)、癌症病史(OR) = 20.34, 95%(CI):3.77-109.79)、住院次數3次以內個案(OR) = 3.81, 95%(CI): 1.10-13.26)及曾入住過加護病房(OR) = 128.06, 95% (CI): 38.25-428.77 )。結論：在研究結果中發現，結核病病患，腎絲球過濾率第Ⅴ分期和癌症者有較大死亡勝算比，死亡的個案多數有因重症而住院或入住過加護病房。 Purpose：This study examined factors associated with the tuberculosis (TB) treatment effectiveness for patients of the elderly. Methods：We conducted a case-control study using the 2006 surveillance data of the Central Tuberculosis Registration, Center for Disease Control, Taiwan. Cases were deceased patients with tuberculosis (TB) and controls were survival patients completed the treatment, patients of both groups were residents of Chang Haw County. The socio-demographic characteristics, history of the disease treatment and co-morbidities were compared. Both descriptive statistics and logistic regression analysis were applied for the data analyses. Result：Among 359 patients receiving TB treatment, 173 cases were deceased and 186 cases completed the treatment. Both groups were similar in the distributions of gender, age and history of smoking. Deceased patients were more prevalent with history of renal disease, cancer and other comorbidities. The results of multivariate logistic regression analysis revealed that factors associated with mortality from TB included the glomerular filtration rate(GFR) in the stage Ⅴ(odds ratio (OR) = 6.32, 95% confidence interval (CI): 1.13-35.28), and history of cancer (OR) = 20.34, 95% (CI): 3.77-109.79), hospitalization for 3 times (OR) = 3.81, 95% (CI): 1.10-13.26) and intensive care (OR) = 128.06, 95% (CI): 38.25-428.77)。 Discussion：TB patients with co-morbidities of glomerular filtration rate(GFR) in the Ⅴstage and cancer are at higher risk of death. The deceased patients are more likely having experiences of hospitalization and/or intensive care.
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