Prediction of tuberculosis-specific mortality for older adult patients with pulmonary tuberculosis
BackgroundThis study aims to identify risk factors associated with tuberculosis-specific mortality (TSM) in older adult patients with pulmonary tuberculosis (TB) and to develop a competing risk nomogram for TSM prediction.MethodsWe conducted a retrospective cohort study and randomly selected 528 old...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1515867/full |
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| author | Sihua Wang Ruohua Gu Pengfei Ren Yu Chen Di Wu Linlin Li |
| author_facet | Sihua Wang Ruohua Gu Pengfei Ren Yu Chen Di Wu Linlin Li |
| author_sort | Sihua Wang |
| collection | DOAJ |
| description | BackgroundThis study aims to identify risk factors associated with tuberculosis-specific mortality (TSM) in older adult patients with pulmonary tuberculosis (TB) and to develop a competing risk nomogram for TSM prediction.MethodsWe conducted a retrospective cohort study and randomly selected 528 older adult pulmonary TB patients hospitalized in designated hospitals in Henan Province between January 2015 and December 2020. The cumulative incidence function (CIF) was calculated for both TSM and non-tuberculosis-specific mortality (non-TSM). A Fine and Gray proportional subdistribution hazards model and a competing risk nomogram were developed to predict TSM in older adult patients.ResultsThe 5-year cumulative incidence functions (CIFs) for TSM and non-TSM were 9.7 and 9.4%, respectively. The Fine and Gray model identified advanced age, retreatment status, chest X-rays (CXR) cavities, and hypoalbuminemia as independent risk factors for TSM. The competing risk nomogram for TSM showed good calibration and excellent discriminative ability, achieving a concordance index (c-index) of 0.844 (95% confidence interval [CI]: 0.830–0.857).ConclusionThe Fine and Gray model provided an accurate evaluation of risk factors associated with TSM. The competing risk nomogram, developed using the Fine and Gray model, provided accurate and personalized predictions of TSM. |
| format | Article |
| id | doaj-art-62c112791073478d9c54ae34477670ee |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Public Health |
| spelling | doaj-art-62c112791073478d9c54ae34477670ee2025-01-15T06:10:40ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011210.3389/fpubh.2024.15158671515867Prediction of tuberculosis-specific mortality for older adult patients with pulmonary tuberculosisSihua Wang0Ruohua Gu1Pengfei Ren2Yu Chen3Di Wu4Linlin Li5The Third People’s Hospital of Henan Province and Henan Hospital for Occupational Diseases, Zhengzhou, Henan Province, ChinaDepartment of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Tuberculosis, The Sixth People' s Hospital of Zhengzhou, Zhengzhou, Henan, ChinaDepartment of Tuberculosis, The Sixth People' s Hospital of Zhengzhou, Zhengzhou, Henan, ChinaThe Third People’s Hospital of Henan Province and Henan Hospital for Occupational Diseases, Zhengzhou, Henan Province, ChinaDepartment of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, ChinaBackgroundThis study aims to identify risk factors associated with tuberculosis-specific mortality (TSM) in older adult patients with pulmonary tuberculosis (TB) and to develop a competing risk nomogram for TSM prediction.MethodsWe conducted a retrospective cohort study and randomly selected 528 older adult pulmonary TB patients hospitalized in designated hospitals in Henan Province between January 2015 and December 2020. The cumulative incidence function (CIF) was calculated for both TSM and non-tuberculosis-specific mortality (non-TSM). A Fine and Gray proportional subdistribution hazards model and a competing risk nomogram were developed to predict TSM in older adult patients.ResultsThe 5-year cumulative incidence functions (CIFs) for TSM and non-TSM were 9.7 and 9.4%, respectively. The Fine and Gray model identified advanced age, retreatment status, chest X-rays (CXR) cavities, and hypoalbuminemia as independent risk factors for TSM. The competing risk nomogram for TSM showed good calibration and excellent discriminative ability, achieving a concordance index (c-index) of 0.844 (95% confidence interval [CI]: 0.830–0.857).ConclusionThe Fine and Gray model provided an accurate evaluation of risk factors associated with TSM. The competing risk nomogram, developed using the Fine and Gray model, provided accurate and personalized predictions of TSM.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1515867/fulltuberculosiscompeting risk modelTB-specific mortalitynomogramolder adult patients |
| spellingShingle | Sihua Wang Ruohua Gu Pengfei Ren Yu Chen Di Wu Linlin Li Prediction of tuberculosis-specific mortality for older adult patients with pulmonary tuberculosis Frontiers in Public Health tuberculosis competing risk model TB-specific mortality nomogram older adult patients |
| title | Prediction of tuberculosis-specific mortality for older adult patients with pulmonary tuberculosis |
| title_full | Prediction of tuberculosis-specific mortality for older adult patients with pulmonary tuberculosis |
| title_fullStr | Prediction of tuberculosis-specific mortality for older adult patients with pulmonary tuberculosis |
| title_full_unstemmed | Prediction of tuberculosis-specific mortality for older adult patients with pulmonary tuberculosis |
| title_short | Prediction of tuberculosis-specific mortality for older adult patients with pulmonary tuberculosis |
| title_sort | prediction of tuberculosis specific mortality for older adult patients with pulmonary tuberculosis |
| topic | tuberculosis competing risk model TB-specific mortality nomogram older adult patients |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1515867/full |
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