ปัจจัยที่สัมพันธ์ต่อการเสียชีวิตของผู้ป่วยวัณโรคปอดเสมหะพบเชื้อ โรงพยาบาลวาปีปทุม อำเภอวาปีปทุม จังหวัดมหาสารคาม

Abstract

ABSTRACT

            Background : Pulmonary tuberculosis remains a major public health concern in Thailand and globally, particularly among patients with smear-positive results, who are at higher risk of transmission and mortality. Identifying factors associated with mortality in this patient group is essential for effective treatment planning and prevention strategies.

            Objective : Determined factors associated with death in smear-positive pulmonary TB patients in Wapipathum Hospital. 

            Methods : A retrospective cohort study was conducted in Wapipathum Hospital. Medical records of new or relapse TB patients with smear positive from 1^st October 2023 to 30^th September 2024 have been reviewed from date of diagnosis, during treatment until patients cured or died. Analysis of characteristics and factors in pulmonary tuberculosis patients who died and those who survived by Fisher’s exact test. Risk differences were calculated by generalized linear model to determine factors associated with mortality.

            Results : 50 smear positive pulmonary TB patients were enrolled, 6 cases died, mortality rate was 12%. 3 cases (50%) died of TB, 4 cases (66.7%) died in first 2 months of treatment. Factors associated with mortality was sputum smear positive 3+ (adjusted risk difference 22.99%, 95% confident interval 8.54%-37.44%)

            Conclusion and Discussion : This study found patients with high grade sputum smear positive associated with mortality. Pulmonary TB screening and fast access for early treatment and closed monitoring in high grade sputum smear positive patients is necessary.

Keywords : Pulmonary Tuberculosis, Mortality, Risk Factors