1. HbA1c level cannot predict the treatment outcome of smear-positive non-multi-drug-resistant HIV-negative pulmonary tuberculosis inpatients
- Author
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Nobuaki Kobayashi, Kenjiro Nagai, Masaki Yamamoto, Atsuya Narita, Yuji Shibata, Ryota Ushio, Kentaro Nakashima, Yu Hara, Nobuyuki Horita, Takashi Sato, Makoto Kudo, Ken Tashiro, Akimichi Nagashima, Takeshi Kaneko, Hiroki Watanabe, Hideyuki Nagakura, Misako Ikeda, and Masaharu Shinkai
- Subjects
Adult ,Male ,medicine.medical_specialty ,Tuberculosis ,Combination therapy ,030209 endocrinology & metabolism ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Tuberculosis, Multidrug-Resistant ,medicine ,Isoniazid ,Humans ,030212 general & internal medicine ,Tuberculosis, Pulmonary ,Rank correlation ,Aged ,Aged, 80 and over ,Glycated Hemoglobin ,Multidisciplinary ,business.industry ,HIV ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Surgery ,Clinical trial ,Treatment Outcome ,Quartile ,Cohort ,Female ,Rifampin ,business ,Rifampicin ,medicine.drug - Abstract
We conducted a single-center retrospective cohort study to evaluate whether the HbA1c level on admission could predict the in-hospital treatment outcome of smear-positive non-multi-drug-resistant HIV-negative culture-proven pulmonary tuberculosis inpatients. Our standard regimens under the direct observation were HRZE or HRE for the first two months followed by combination therapy with isoniazid and rifampicin. Our cohort consisted of consecutive 239 patients consisted of 147 men and 92 women with a median age of 73 years. The HbA1c level of patients whose HbA1c was above 7.0% on admission showed clear declining trends after admission. HbA1c on admission had no Spearman’s rank correlation with time to discharge alive (r = 0.17) and time to becoming non-infective (r = 0.17). By Kaplan-Meier curves and a log-rank trend test, HbA1c quartile subgroups showed no association with times to discharge alive (p = 0.431), becoming non-infective (p = 0.113), and in-hospital death (p = 0.427). Based on multi-variate Cox analysis, HbA1c on admission had no significant impact on time to discharge alive (hazard ratio = 1.03, 95% CI 0.89–1.20, p = 0.659), becoming non-infective (hazard ratio = 0.93, 95% CI 0.80–1.06, p = 0.277), and in-hospital death (hazard ratio = 0.68, 0.43–1.07, p = 0.097). In conclusion, the HbA1c level on admission did not seem to affect in-hospital tuberculosis treatment outcomes in Japanese cohort.
- Published
- 2016