MORTALITY AMONG TUBERCULOSIS PATIENTS IN THE NETHERLANDS IN THE PERIOD 1993-1995

This study aimed to estimate excess mortality among tuberculosis patie nts in the Netherlands and identify risk factors far tuberculosis-asso ciated mortality. The national tuberculosis register provided data on patients diagnosed in the period 1993-1995. Excess mortality in tuberc ulosis cases, according to age and ses, was determined by comparison w ith national mortality rates. Risk factors were identified and adjustm ent for confounders was carried out using Cox's proportional hazard an alysis, Of 4,340 patients alive at diagnosis, 258 died within 1 gr whi le on treatment. The Kaplan-Meier survival probability after 1 yr was 93%. Tuberculosis patients had a standardized mortality ratio of 8.3. Independent risk factors for mortality were: gender; age; presence of a malignancy or human immunodeficiency virus (HIV) infection; addictio n to alcohol or drugs; localization of tuberculosis; and the type of m edical officer having made the diagnosis, Of all deaths, 83% occurred in two risk groups comprising 21% of tuberculosis patients: those aged greater than or equal to 65 yrs and those having HIV infection or a m alignancy. Tuberculosis patients in the Netherlands are at a considera bly increased risk of death, However, the prognosis is very good for t hose aged less than 65 yrs and without human immunodeficiency virus in fection or a malignancy.