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Survival and predictors of mortality in tuberculosis in north-central Mexico. A 5-year analytical cohort
Survival and predictors of mortality in tuberculosis in north-central Mexico. A 5-year analytical cohort
Juan C. Borrego-Moreno 1 
, Fátima P. Ávila-Hernández 2 , Bruno Rivas-Santiago 3 , Carmen J. Serrano 4
1 Hospital General de Zona 1, Instituto Mexicano del Seguro Social (IMSS), Zacatecas, Zac. México; 2 Unidad Académica de Medicina Humana y Ciencias de la Salud, Universidad Autónoma de Zacatecas, Zacatecas, Zac. México; 3 Unidad de Investigación Biomédica Zacatecas, IMSS, Zacatecas, Zac., México; 4 Unidad de Investigación Biomédica Zacatecas, IMSS, Zacatecas, Zac. México
*Correspondence: Carmen J. Serrano. Email: carmenyuyu2000@yahoo.com.mx
Abstract
Background: Survival after tuberculosis (TB) treatment is poorly documented in Mexico. Objective: To determine the predictors of 5-year survival and mortality in TB in North-Central Mexico. Materials and methods: Retrospective cohort study (2019-2023) of adult patients treated at the Mexican Institute of Social Security (IMSS) in Zacatecas, confirmed by culture or nucleic acid amplification testing. Results: A mortality rate of 17.6% was observed. In the logistic regression, independent factors associated with death were carriage of a rifampicin-resistant Mycobacterium tuberculosis (Mtb) strain, seizures, a neutrophil-to-lymphocyte ratio (NLR) ≥ 10 points at diagnosis, a diagnosis of miliary TB, and reported alcoholism. Overall survival, with a mean follow-up of 32 months, was 74.3%. In Cox regression, 33% of rifampicin-resistant cases had survival time < 20 months; 17% of patients with NLR ≥ 10 had survival time < 40 months; 30% of patients with miliary TB had survival time < 20 months; and the survival probability among those with alcoholism was 57.7% at 30 months. After 5 years, all patients with miliary TB or alcoholism had died. Conclusions: Recognizing factors linked to poor survival can inform preventive strategies to improve outcomes in patients with TB.
Keywords: Tuberculosis. Survival. Risk factors. Prevention.
