C Andrew Basham1,2, Mohammad Ehsanul Karim3,4, Victoria J Cook5,6, David M Patrick3,5, James C Johnston3,5,6. 1. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. umbashac@myumanitoba.ca. 2. British Columbia Centre for Disease Control, 655 W 12th Ave., Vancouver, BC, V5Z 4R4, Canada. umbashac@myumanitoba.ca. 3. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. 4. Centre for Health Evaluation and Outcomes Science, University of British Columbia, Vancouver, BC, Canada. 5. British Columbia Centre for Disease Control, 655 W 12th Ave., Vancouver, BC, V5Z 4R4, Canada. 6. Division of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada.
Abstract
OBJECTIVE: To compare non-tuberculosis (non-TB)-cause mortality risk overall and cause-specific mortality risks within the immigrant population of British Columbia (BC) with and without TB diagnosis through time-dependent Cox regressions. METHODS: All people immigrating to BC during 1985-2015 (N = 1,030,873) were included with n = 2435 TB patients, and the remaining as non-TB controls. Outcomes were time-to-mortality for all non-TB causes, respiratory diseases, cardiovascular diseases, cancers, and injuries/poisonings, and were ascertained using ICD-coded vital statistics data. Cox regressions were used, with a time-varying exposure variable for TB diagnosis. RESULTS: The non-TB-cause mortality hazard ratio (HR) was 4.01 (95% CI 3.57-4.51) with covariate-adjusted HR of 1.69 (95% CI 1.50-1.91). Cause-specific covariate-adjusted mortality risk was elevated for respiratory diseases (aHR = 2.96; 95% CI 2.18-4.00), cardiovascular diseases (aHR = 1.63; 95% CI 1.32-2.02), cancers (aHR = 1.40; 95% CI 1.13-1.75), and injuries/poisonings (aHR = 1.85; 95% CI 1.25-2.72). CONCLUSIONS: In any given year, if an immigrant to BC was diagnosed with TB, their risk of non-TB mortality was 69% higher than if they were not diagnosed with TB. Healthcare providers should consider multiple potential threats to the long-term health of TB patients during and after TB treatment. TB guidelines in high-income settings should address TB survivor health.
OBJECTIVE: To compare non-tuberculosis (non-TB)-cause mortality risk overall and cause-specific mortality risks within the immigrant population of British Columbia (BC) with and without TB diagnosis through time-dependent Cox regressions. METHODS: All people immigrating to BC during 1985-2015 (N = 1,030,873) were included with n = 2435 TBpatients, and the remaining as non-TB controls. Outcomes were time-to-mortality for all non-TB causes, respiratory diseases, cardiovascular diseases, cancers, and injuries/poisonings, and were ascertained using ICD-coded vital statistics data. Cox regressions were used, with a time-varying exposure variable for TB diagnosis. RESULTS: The non-TB-cause mortality hazard ratio (HR) was 4.01 (95% CI 3.57-4.51) with covariate-adjusted HR of 1.69 (95% CI 1.50-1.91). Cause-specific covariate-adjusted mortality risk was elevated for respiratory diseases (aHR = 2.96; 95% CI 2.18-4.00), cardiovascular diseases (aHR = 1.63; 95% CI 1.32-2.02), cancers (aHR = 1.40; 95% CI 1.13-1.75), and injuries/poisonings (aHR = 1.85; 95% CI 1.25-2.72). CONCLUSIONS: In any given year, if an immigrant to BC was diagnosed with TB, their risk of non-TBmortality was 69% higher than if they were not diagnosed with TB. Healthcare providers should consider multiple potential threats to the long-term health of TBpatients during and after TB treatment. TB guidelines in high-income settings should address TB survivor health.
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