Setting: Health Department Tuberculosis (TB) Control program, Connecticut, United States
Objective: 1) To assess TB-relatedness of deaths and missed opportunities among Connecticut patients who died with TB, and 2) to identify factors associated with death.
Design: The study population consisted of all persons diagnosed with TB and reported to the Connecticut TB Control Program during 2007-2009. TB Control Program records, medical records, autopsy reports and death certificates of decedents were reviewed. A tool was used to categorize TB-relatedness of deaths and identify missed opportunities in diagnosis and medical treatment among TB-related deaths. Surveillance data regarding TB survivors were used for comparison to identify factors associated with death.
Results: During 2007-2009, 20/300 (7%) persons with TB died; 14 (70%) decedents had at least one medical comorbidity and 17 (85%) deaths were TB-related. Among patients who had a TB-related death, 16 (94%) had ≥1 missed opportunity identified. Excess alcohol use (risk ratio [RR] 4.4, 95% confidence interval [CI] 1.8-11.0) and age > 64 years (RR 5.7, 95%CI 2.5-13.1) were associated with death.
Conclusions: The majority of deaths among Connecticut TB patients were TB-related. Missed opportunities were common. Excess alcohol use and older age might indicate a need for monitoring to prevent death.