Mortality in patients with multidrug-resistant tuberculosis in a tertiary care hospital in Lima, Peru

Introduction: In recent years, an increase in the number of multidrug-resistant (MDR) tuberculosis (MDR-TB) cases has been reported worldwide. This implies an increase in mortality rates due to the complex treatment of MDR-TB and the presence of different risk factors in these patients. Objective: To determine the risk factors for mortality in patients with MDR-TB treated at the pulmonology service of the Hospital Nacional Dos de Mayo (Lima, Peru) between 2014 and 2018. Materials and methods: Retrospective case-control study conducted in 305 MDR-TB patients hospitalized between 2014 and 2018 (cases: 62; controls: 243). Cases were defined as patients who died. Data on variables of interest were obtained from medical records. A bivariate and a multivariate analysis (logistic regression model) were performed by calculating odds ratios (crude and adjusted) to determine the association between the variables considered in this study and mortality. Results: Participants’ mean age was 48.2±19.4 years. In the multivariate analysis, having diabetes mellitus (aOR: 8.580, 95%CI: 1.805-40.785), having a history of TB (aOR: 4.923, 95%CI: 1.474-16.446), being an active smoker (aOR: 12.189, 95%CI: 3.047-48.759), using psychoactive drugs (aOR: 9.428, CI95%: 2.737-32.482), and being malnourished (aOR: 6.652, CI95%: 1.432-30.888) were associated with an increased risk of mortality due to MDR-TB. Conclusions: In this study, several risk factors for mortality in MDR-TB patients were identified. Strategies for the adequate management of MDR-TB, particularly in patients with the mortality risk factors identified here, must be implemented at the Hospital Nacional Dos de Mayo, as well as other hospitals that provide healthcare services to these patients in Lima.