TY - JOUR T1 - Survival and risk factors of mortality among defaulters from treatment of pulmonary tuberculosis JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - 202 AU - Alan Altraja AU - Piret Viiklepp AU - Lea Pehme Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/202.abstract N2 - Defaulters from treatment of pulmonary tuberculosis (PTB) convey a significant transmission risk that is particularly dangerous during increasing prevalence of MDR-TB and TB/HIV co-infection.We estimated 1- and 5-year survival, assessed infectiousness and identified risk factors of mortality of PTB patients after treatment default.We observed all patients with PTB registered in the Estonian Tuberculosis Registry as defaulters during 2004-2006 (n=160) in a cohort study until 12.12.2011 and used multivariate Cox regression analysis to identify risk factors of mortality.Median follow-up time was 5.94 (IQR 3.21-6.68) years after default. One-year and 5-year survivals were 90.5% and 68.8%, respectively. Among the 50 patients (31.3%) who died, median survival time was 1.86 (IQR 0.88-3.04) years; 24 deaths (48.0%) occurred due to TB and 26 (52.0%) due to other reasons. At 1 and 5 years after default, 22.8% and 12.2% of surviving patients, respectively, were smear/culture positive.Smear-positivity (HR 2.86, 95% CI 1.05–7.80), previous TB (HR 2.99 95% CI 1.27–7.04) and ofloxacin resistance (HR 5.77, 95% CI 1.74–19.18) increased risk of TB-related mortality. Disabled (HR 7.97, 95% CI 1.01–62.63), retired (HR 17.10, 95% CI 1.71–171.41), homeless (HR 2.36, 95% CI 1.61–4.78) and imprisoned people (HR 34.01, 95% CI 2.92–398.11) were at increased risk of all-cause mortality, whereas targeted case detection by medical personnel lowered this risk (HR 0.19, 95% CI 0.56–0.61).Among defaulters, TB-related mortality is not associated with demographic factors, which influence all-cause mortality instead. Infectiousness of defaulters remains high, though decreases with time.Funded by ESF grant No. 8188. ER -