Mortality of patients hospitalized for active tuberculosis in Israel

Background: Pulmonary tuberculosis continues to be a major cause of mortality, particularly in developing countries. Despite modern anti-TB treatment, the elderly and immigrants from TB-endemic countries are at risk. Multidrug resistance has yet to be resolved. Objectives: To determine the mortality rate and predictors of mortality among patients hospitalized with TB in Israel. Methods: We evaluated the medical records of 461 patients with active pulmonary TB who were hospitalized in the respiratory care department during the 5 year period 200-2004. Data included demographic, clinical, laboratory and radiological findings, drug resistance as well as adverse reactions to anti-TB treatment. Results: Three main ethno-geographic groups were observed: 253 patients from the former USSR, 130 from Ethiopia, and 54 of Israeli origin (as well as 24 residents of other countries). Of the 461 patients 65 (13%) died in hospital. The factors that were best predictors of mortality were older age, ischemic heart disease, cachexia, prior corticosteroid treatment, hypoalbuminemia and pleural effusion (P < 0.005 for all). The ethno-geographic factor and the presence of multidrug-resistant bacteria had no significant effect on mortality in our study group. Conclusions: The mortality rate in our study was relatively low, and there was no significant difference between the three ethno-geographic groups.