The Role of Tuberculosis in COPD Clinical Trial
Official title:
The Role of Tuberculosis in Chronic Obstructive Lung Disease
Influence of tuberculosis (TB) on natural course of chronic obstructive lung disease (COPD) has not been well known. This study was designed to investigate the effects of history of TB on the long-term course of COPD.
Patients hospitalized with COPD exacerbation were consecutively included (n=598). Cases were
classified into two categories: those with a history of TB and those without. Clinical,
demographic, and radiological features were meticulously recorded and patients were followed
up for mortality. 93 patients (15%) had past TB. On average, patients with a history of TB
were four-year younger (p=0.002). Our study revealed that patients with TB history were
diagnosed with COPD five-year earlier and died five-year earlier as compared to the patients
without TB. In addition, in the TB history positive group, the rate of hospital admissions
per year was higher compared to the group that lacked TB history (2.46±0.26 vs. 1.56±0.88;
p=0.001). The patients with TB history had higher PaCO2 and lower FEV1 (p=0.008 and p=0.069
respectively). Median survival was 24 months for patients with past TB, and was 36 months
for those without. Kaplan-Meier analysis revealed that although 3-year survival rate was
lower in patients with TB history, it was not statistically significant (p=0.08). Cox
regression analysis showed that while factors such as age, PaCO2, hematocrit, BMI and the
Charlson index affected mortality rates in COPD patients (p<0.05), prior history of TB did
not seem to have a significant impact on the mortality.
Our results showed that past TB caused more hospitalizations, lower respiratory functions
and higher arterial carbon dioxide levels. It was found that, though the mortality rates
were similar, COPD patients with past TB was diagnosed and died five-year earlier. We
conclude that history of TB has an important role in natural course of COPD.
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Observational Model: Cohort, Time Perspective: Prospective