Borjas-Howard, J.F. (2013) Tuberculosebehandeling in Beatrixoord: kwantitatieve analyse van behandeluitkomsten. thesis, Medicine.
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Abstract
Background: The TB-unit in Beatrixoord, The Netherlands is a dedicated tertiary center for treatment of TB patients who are infectious and require long-term isolation. The unit also admits patients considered to be medically and/or socially complex given that their management in an outpatients setting poses a high risk of an unfavorable outcome. The TB-unit applies a multidisciplinary approach which manages these factors and thereby theoretically lowers the chances of an unfavorable treat-ment outcome. Goal: to quantitatively evaluate treatment outcomes in a cohort of patients with a high prevalence of medical and social risk factors. Design: Retrospective cohort study. Patients: All patients treated for TB in the Beatrixoord TB-unit from 2000 through 2010. These were also compared to a co-hort of patients from the National Tuberculosis Registry (NTR) within the same timeframe. Results: 801 patients were included in the analysis. 698 (87%) had a favourable treatment outcome. The following factors were associated with an unfavorable outcome in a multivariate logistic regression analysis: amount of comorbidities; previous defaulting/failure from treatment, immigration from East-Europe, former Soviet Union and Asia; alcohol and/or drug abuse. In the comparative analysis favourable treatment outcome percentages were comparable across most groups. There was a statistically significant higher rate of treatment success (in favor of the Beatrixoord cohort) among patients who were homeless (p = 0,03), illegal immigrants (p = 0,03) or had 2 or more social risk factors (p = <0,01). Limitations: There is a possible follow-up and selection bias in the comparative analysis between the cohorts. Conclusions: A treatment success percentage above WHO-standards (85%) was achieved despite a high prevalence of risk factors. Despite the mentioned bias, these results support the view that admission to a specialized TB-unit might aid in im-proving treatment success among patients with a high risk profile due to medical and social characteristics.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Werf, Prof. Dr. T.S. van der |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:05 |
| Last Modified: | 25 Jun 2020 11:05 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2498 |
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