Clinical Characteristics and Prognostic Analysis of Patients With Pulmonary Tuberculosis and Type 2 Diabetes Comorbidity in China: A Retrospective Analysis

Abstract

Background: Tuberculosis (TB) is one of the leading communicable diseases, with significant morbidity and mortality. Diabetes can increase the risk of developing TB and the related adverse outcomes. This study retrospectively analyzed the clinical characteristics and prognosis of patients with pulmonary TB and type 2 diabetes comorbidity.Methods: About 282 cases with pulmonary TB and type 2 diabetes comorbidity were identified from West China Hospital between January 1, 2010, and December 31, 2016, and were followed up for at least 3 years. We further used Kaplan–Meier methods and COX regression analysis to identify the influence factors for all-cause death.Results: Compared to the survival patients, patients who died were older, exhibited significantly lower albumin and hemoglobin levels, but higher Charlson Comorbidity Index (CCI) score at admission, and had a lower usage rate of metformin. The all-cause mortality rates at 1 and 5 years were 5.67 and 20.59%, separately. For 1-year all-cause death, higher albumin level (HR = 0.90, 95% CI: 0.81–0.99) was the independently protective factor, but older age (HR = 1.07, 95% CI: 1.01–1.13) and CCI score ≥3 (HR = 6.77, 95% CI: 1.40–32.69) were the independent risk factors. For long-term all-cause death, higher albumin level (HR = 0.94, 95% CI: 0.88–1.00), the use of metformin (HR = 0.21, 95% CI: 0.07–0.59), insulin (HR = 0.27, 95% CI: 0.10–0.74), or sulfonylureas (HR = 0.23, 95% CI: 0.07–0.74) were the independently protective factors, but older age (HR = 1.03, 95% CI: 1.00–1.07) and CCI score ≥3 (HR = 7.15, 95% CI: 2.56–19.92) were the independent risk factors.Conclusions: The lower albumin level, older age, and CCI score ≥3 were predictors of all-cause death in patients with pulmonary TB and type 2 diabetes comorbidity. In the long run, patients who use metformin, insulin, or sulfonylureas as hypoglycemic agents may have a lower incidence of death.