Chest
Clinical InvestigationsTuberculosis Diagnosed at Death in the United States
Section snippets
MATERIALS AND METHODS
Since 1985, all states have submitted individual reports on each TB case to the CDC. The standard definition used by state and city health departments for reporting the vital status (alive or dead) to the CDC is written in the guide for completing case reports as follows: “Patients whose tuberculosis was suspected and who were started on at least two antituberculosis drugs prior to the day of death are classified as alive at the time of diagnosis even though the case is not verified and counted
RESULTS
Of the 86,292 cases analyzed, 81,919 (94.9 percent) were diagnosed while patients were alive, and 4,373 cases (5.1 percent) were diagnosed at death (Table 1).
Of the total cases diagnosed at death, 60.3 percent (2,636) were 65 years of age or older. The observed proportion of cases diagnosed at death increased with age from 0.7 percent in patients less than 5 years old to 18.6 percent in patients 85 years and older. Adjustments for differences in race/ethnicity, sex, place of birth and disease
DISCUSSION
Over the four-year period from 1985 to 1988, 5.1 percent of nationally reported TB cases were diagnosed at death. The most important observation was that increasing age and site of disease (miliary, meningeal and peritoneal) were the variables most strongly associated with the likelihood that TB would be reported at death. That advanced age and site of disease were of overriding importance is best evidenced by the small changes in proportions of these two variables after adjustment for the
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Manuscript received August 20; revision accepted January 17.