TY - JOUR
T1 - Respiratory health status is associated with treatment outcomes in pulmonary tuberculosis
AU - Gupte, A. N.
AU - Selvaraju, S.
AU - Paradkar, M.
AU - Danasekaran, K.
AU - Shivakumar, S. V.B.Y.
AU - Thiruvengadam, K.
AU - Dolla, C.
AU - Shivaramakrishnan, G.
AU - Pradhan, N.
AU - Kohli, R.
AU - John, S.
AU - Raskar, S.
AU - Jain, D.
AU - Momin, A.
AU - Subramanian, B.
AU - Gaikwad, A.
AU - Lokhande, R.
AU - Suryavanshi, N.
AU - Gupte, N.
AU - Salvi, S.
AU - Murali, L.
AU - Checkley, W.
AU - Golub, J. E.
AU - Bollinger, R.
AU - Chandrasekaran, P.
AU - Mave, V.
AU - Gupta, A.
N1 - Publisher Copyright:
© 2019 The Union.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - BACKGROUND: The association between respiratory impairment and tuberculosis (TB) treatment outcomes is not clear. METHODS : We prospectively evaluated respiratory health status, measured using the Saint George's Respiratory Questionnaire (SGRQ), in a cohort of new adult pulmonary TB cases during and up to 18 months following treatment in India. Associations between total SGRQ scores and poor treatment outcomes of failure, recurrence and all-cause death were measured using multivariable Poisson regression. RESULTS : We enrolled 455 participants contributing 619 person-years at risk; 39 failed treatment, 23 had recurrence and 16 died. The median age was 38 years (interquartile range 26-49); 147 (32%) ever smoked. SGRQ scores at treatment initiation were predictive of death during treatment (14% higher risk per 4-point increase in baseline SGRQ scores, 95%CI 2-28, P = 0.01). Improvement in SGRQ scores during treatment was associated with a lower risk of failure (1% lower risk for every per cent improvement during treatment, 95%CI 1-2, P = 0.05). Clinically relevant worsening in SGRQ scores following successful treatment was associated with a higher risk of recurrence (15% higher risk per 4-point increase scores, 95%CI 4-27, P = 0.004). CONCLUS ION: Impaired respiratory health status was associated with poor TB treatment outcomes. The SGRQ may be used to monitor treatment response and predict the risk of death in pulmonary TB.
AB - BACKGROUND: The association between respiratory impairment and tuberculosis (TB) treatment outcomes is not clear. METHODS : We prospectively evaluated respiratory health status, measured using the Saint George's Respiratory Questionnaire (SGRQ), in a cohort of new adult pulmonary TB cases during and up to 18 months following treatment in India. Associations between total SGRQ scores and poor treatment outcomes of failure, recurrence and all-cause death were measured using multivariable Poisson regression. RESULTS : We enrolled 455 participants contributing 619 person-years at risk; 39 failed treatment, 23 had recurrence and 16 died. The median age was 38 years (interquartile range 26-49); 147 (32%) ever smoked. SGRQ scores at treatment initiation were predictive of death during treatment (14% higher risk per 4-point increase in baseline SGRQ scores, 95%CI 2-28, P = 0.01). Improvement in SGRQ scores during treatment was associated with a lower risk of failure (1% lower risk for every per cent improvement during treatment, 95%CI 1-2, P = 0.05). Clinically relevant worsening in SGRQ scores following successful treatment was associated with a higher risk of recurrence (15% higher risk per 4-point increase scores, 95%CI 4-27, P = 0.004). CONCLUS ION: Impaired respiratory health status was associated with poor TB treatment outcomes. The SGRQ may be used to monitor treatment response and predict the risk of death in pulmonary TB.
KW - Saint George's Respiratory Questionnaire
KW - TB
KW - respiratory health status
KW - treatment outcomes
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U2 - 10.5588/ijtld.18.0551
DO - 10.5588/ijtld.18.0551
M3 - Article
C2 - 31064624
AN - SCOPUS:85065762406
SN - 1027-3719
VL - 23
SP - 450
EP - 457
JO - International Journal of Tuberculosis and Lung Disease
JF - International Journal of Tuberculosis and Lung Disease
IS - 4
ER -