Respiratory health status is associated with treatment outcomes in pulmonary tuberculosis

A. N. Gupte, S. Selvaraju, M. Paradkar, K. Danasekaran, S. V.B.Y. Shivakumar, K. Thiruvengadam, C. Dolla, G. Shivaramakrishnan, N. Pradhan, R. Kohli, S. John, S. Raskar, D. Jain, A. Momin, B. Subramanian, A. Gaikwad, R. Lokhande, N. Suryavanshi, Nikhil Gupte, S. Salvi & 7 others L. Murali, William Checkley, Jonathan E Golub, Robert C Bollinger, P. Chandrasekaran, Vidya Mave, Amita Gupta

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The association between respiratory impairment and tuberculosis (TB) treatment outcomes is not clear. METHODS : We prospectively evaluated respiratory health status, measured using the Saint George's Respiratory Questionnaire (SGRQ), in a cohort of new adult pulmonary TB cases during and up to 18 months following treatment in India. Associations between total SGRQ scores and poor treatment outcomes of failure, recurrence and all-cause death were measured using multivariable Poisson regression. RESULTS : We enrolled 455 participants contributing 619 person-years at risk; 39 failed treatment, 23 had recurrence and 16 died. The median age was 38 years (interquartile range 26-49); 147 (32%) ever smoked. SGRQ scores at treatment initiation were predictive of death during treatment (14% higher risk per 4-point increase in baseline SGRQ scores, 95%CI 2-28, P = 0.01). Improvement in SGRQ scores during treatment was associated with a lower risk of failure (1% lower risk for every per cent improvement during treatment, 95%CI 1-2, P = 0.05). Clinically relevant worsening in SGRQ scores following successful treatment was associated with a higher risk of recurrence (15% higher risk per 4-point increase scores, 95%CI 4-27, P = 0.004). CONCLUS ION: Impaired respiratory health status was associated with poor TB treatment outcomes. The SGRQ may be used to monitor treatment response and predict the risk of death in pulmonary TB.

Original languageEnglish (US)
Pages (from-to)450-457
Number of pages8
JournalInternational Journal of Tuberculosis and Lung Disease
Volume23
Issue number4
DOIs
StatePublished - Apr 1 2019

Fingerprint

Pulmonary Tuberculosis
Health Status
Recurrence
Tuberculosis
Surveys and Questionnaires
Treatment Failure
India
Cause of Death

Keywords

  • respiratory health status
  • Saint George's Respiratory Questionnaire
  • TB
  • treatment outcomes

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Gupte, A. N., Selvaraju, S., Paradkar, M., Danasekaran, K., Shivakumar, S. V. B. Y., Thiruvengadam, K., ... Gupta, A. (2019). Respiratory health status is associated with treatment outcomes in pulmonary tuberculosis. International Journal of Tuberculosis and Lung Disease, 23(4), 450-457. https://doi.org/10.5588/ijtld.18.0551

Respiratory health status is associated with treatment outcomes in pulmonary tuberculosis. / Gupte, A. N.; Selvaraju, S.; Paradkar, M.; Danasekaran, K.; Shivakumar, S. V.B.Y.; Thiruvengadam, K.; Dolla, C.; Shivaramakrishnan, G.; Pradhan, N.; Kohli, R.; John, S.; Raskar, S.; Jain, D.; Momin, A.; Subramanian, B.; Gaikwad, A.; Lokhande, R.; Suryavanshi, N.; Gupte, Nikhil; Salvi, S.; Murali, L.; Checkley, William; Golub, Jonathan E; Bollinger, Robert C; Chandrasekaran, P.; Mave, Vidya; Gupta, Amita.

In: International Journal of Tuberculosis and Lung Disease, Vol. 23, No. 4, 01.04.2019, p. 450-457.

Research output: Contribution to journalArticle

Gupte, AN, Selvaraju, S, Paradkar, M, Danasekaran, K, Shivakumar, SVBY, Thiruvengadam, K, Dolla, C, Shivaramakrishnan, G, Pradhan, N, Kohli, R, John, S, Raskar, S, Jain, D, Momin, A, Subramanian, B, Gaikwad, A, Lokhande, R, Suryavanshi, N, Gupte, N, Salvi, S, Murali, L, Checkley, W, Golub, JE, Bollinger, RC, Chandrasekaran, P, Mave, V & Gupta, A 2019, 'Respiratory health status is associated with treatment outcomes in pulmonary tuberculosis', International Journal of Tuberculosis and Lung Disease, vol. 23, no. 4, pp. 450-457. https://doi.org/10.5588/ijtld.18.0551
Gupte AN, Selvaraju S, Paradkar M, Danasekaran K, Shivakumar SVBY, Thiruvengadam K et al. Respiratory health status is associated with treatment outcomes in pulmonary tuberculosis. International Journal of Tuberculosis and Lung Disease. 2019 Apr 1;23(4):450-457. https://doi.org/10.5588/ijtld.18.0551
Gupte, A. N. ; Selvaraju, S. ; Paradkar, M. ; Danasekaran, K. ; Shivakumar, S. V.B.Y. ; Thiruvengadam, K. ; Dolla, C. ; Shivaramakrishnan, G. ; Pradhan, N. ; Kohli, R. ; John, S. ; Raskar, S. ; Jain, D. ; Momin, A. ; Subramanian, B. ; Gaikwad, A. ; Lokhande, R. ; Suryavanshi, N. ; Gupte, Nikhil ; Salvi, S. ; Murali, L. ; Checkley, William ; Golub, Jonathan E ; Bollinger, Robert C ; Chandrasekaran, P. ; Mave, Vidya ; Gupta, Amita. / Respiratory health status is associated with treatment outcomes in pulmonary tuberculosis. In: International Journal of Tuberculosis and Lung Disease. 2019 ; Vol. 23, No. 4. pp. 450-457.
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AU - Gupte, A. N.

AU - Selvaraju, S.

AU - Paradkar, M.

AU - Danasekaran, K.

AU - Shivakumar, S. V.B.Y.

AU - Thiruvengadam, K.

AU - Dolla, C.

AU - Shivaramakrishnan, G.

AU - Pradhan, N.

AU - Kohli, R.

AU - John, S.

AU - Raskar, S.

AU - Jain, D.

AU - Momin, A.

AU - Subramanian, B.

AU - Gaikwad, A.

AU - Lokhande, R.

AU - Suryavanshi, N.

AU - Gupte, Nikhil

AU - Salvi, S.

AU - Murali, L.

AU - Checkley, William

AU - Golub, Jonathan E

AU - Bollinger, Robert C

AU - Chandrasekaran, P.

AU - Mave, Vidya

AU - Gupta, Amita

PY - 2019/4/1

Y1 - 2019/4/1

N2 - BACKGROUND: The association between respiratory impairment and tuberculosis (TB) treatment outcomes is not clear. METHODS : We prospectively evaluated respiratory health status, measured using the Saint George's Respiratory Questionnaire (SGRQ), in a cohort of new adult pulmonary TB cases during and up to 18 months following treatment in India. Associations between total SGRQ scores and poor treatment outcomes of failure, recurrence and all-cause death were measured using multivariable Poisson regression. RESULTS : We enrolled 455 participants contributing 619 person-years at risk; 39 failed treatment, 23 had recurrence and 16 died. The median age was 38 years (interquartile range 26-49); 147 (32%) ever smoked. SGRQ scores at treatment initiation were predictive of death during treatment (14% higher risk per 4-point increase in baseline SGRQ scores, 95%CI 2-28, P = 0.01). Improvement in SGRQ scores during treatment was associated with a lower risk of failure (1% lower risk for every per cent improvement during treatment, 95%CI 1-2, P = 0.05). Clinically relevant worsening in SGRQ scores following successful treatment was associated with a higher risk of recurrence (15% higher risk per 4-point increase scores, 95%CI 4-27, P = 0.004). CONCLUS ION: Impaired respiratory health status was associated with poor TB treatment outcomes. The SGRQ may be used to monitor treatment response and predict the risk of death in pulmonary TB.

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