อัตราการรอดชีพของผู้ป่วยวัณโรคปอดและปัจจัยที่มีความสัมพันธ์กับการเสียชีวิตจากวัณโรคปอด ในโรงพยาบาลสมเด็จพระยุพราชสระแก้ว

Surachai  Supcharassaeng

Authors

Surachai Supcharassaeng Sakaeo Crown Prince Hospital

Keywords:

Pulmonary tuberculosis, survival rate, associated factors

Abstract

Background: Pulmonary tuberculosis (PTB) remains a major public health concern in Thailand. Despite advancements in diagnostic and treatment systems, mortality rates remain high, particularly in Sa Kaeo Province, a border area where both the proportion of PTB cases and mortality rates exceed the national average.

Objective: To estimate the survival rates of pulmonary tuberculosis patients at 6 months, 1, 3, and 5 years, and to identify factors associated with all-cause mortality among PTB patients at Sakaeo Crown Prince Hospital.

Methods: This retrospective cohort study included 266 PTB patients aged ≥18 years who initiated treatment at Sakaeo Crown Prince Hospital between 2018 and 2019. Patients were followed until death or the end of the study period (December 31, 2024). Survival outcomes were assessed using the Kaplan–Meier method, and prognostic factors were analyzed using Cox proportional hazards regression to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Statistical significance was set at p-value <0.05.

Results: The median survival time was 61 months. The survival probabilities at 6 months, 1, 3, and 5 years were 68% (95% CI: 62.46-73.64), 65.0% (95% CI: 58.9–70.4), 56.0% (95% CI: 50.2–62.1), and 50.0% (95% CI: 44.2–56.2), respectively. In multivariable analysis, significant predictors of mortality included male sex (Adj. HR = 1.60, 95% CI: 1.02–2.51, p-value = 0.04), age >50 years (Adj. HR = 2.08, 95% CI: 1.35–3.22, p-value < 0.01), chronic kidney disease (CKD) (Adj. HR = 1.79, 95% CI: 1.23–2.60, p-value < 0.01), sepsis (Adj. HR = 2.55, 95% CI: 1.38–4.71, p-value < 0.01) , pneumonia (Adj. HR = 2.09, 95% CI: 1.22–3.60, p-value < 0.01), as well as those with poor adherence to anti-TB treatment (Adj. HR = 2.43, 95% CI: 1.26–4.71, p-value < 0.01)

Conclusion: The 5-year survival rate of PTB patients in this cohort was only 50%. Male sex, older age, sepsis, pneumonia, and poor adherence to TB treatment were identified as independent risk factors for mortality. These findings highlight the urgent need for targeted surveillance and intensive clinical management of high-risk groups, and can inform future screening strategies, clinical interventions, and public health policies aimed at reducing TB-related mortality at regional levels.

Keywords: Pulmonary tuberculosis, survival rate, and associated factors

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